Jebs Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

0201003350 Issued in VA

Legal business name

JEBS INC

Doing business as

Medicap Pharmacy

Practice address

4375 Brambleton Ave
Roanoke, VA 24018-3404

Phone

(540) 772-0605

Fax

(540) 772-0601

NPI assigned

Nov 22, 2005

Last updated

Mar 7, 2023By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Walter Steven Nuckols, RPH

Title

Owner Pharmacist

Phone

(540) 772-0605

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Medicap Pharmacy Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1132617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1255314258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4375 BRAMBLETON AVE",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240183404",
            "telephone_number": "540-772-0605",
            "fax_number": "540-772-0601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4375 BRAMBLETON AVE",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240183404",
            "telephone_number": "540-772-0605",
            "fax_number": "540-772-0601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEBS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-22",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "NUCKOLS",
        "authorized_official_first_name": "WALTER",
        "authorized_official_middle_name": "STEVEN",
        "authorized_official_title_or_position": "OWNER PHARMACIST",
        "authorized_official_telephone_number": "540-772-0605",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "VA",
            "license": "0201003350",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8508399",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP #",
            "identifier": "4829909",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medicap Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Daniel K Janyja, MD
• Jeremy Jasperse
• Jearls Nutrition, LLC
• Emilie Jearls, RBT
• Kristie Jearls, RD
• Jefferson Internal Medicine Associates, LTD
• Jefferson Surgical Clinic Inc
• Monique C Jefferson, AGACNP-BC
• William Emmett Jefferson III, MD
• David Lee Jeffries, AGACNP-BC

• Community/Retail Pharmacy in Roanoke, VA
• Providers in Roanoke, VA by specialty
• Community/Retail Pharmacy in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.