Jefferson Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

06118 Issued in TX

Legal business name

JEFFERSON PHARMACY INC

Doing business as

Jefferson Pharmacy

Practice address

917 Manor Dr
San Antonio, TX 78228-3227

Phone

(210) 734-5133

Fax

(210) 735-8815

NPI assigned

Mar 1, 2007

Organization subpart

No

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

Authorized official

Name

Kevin Kennedy

Title

Managing Member

Phone

(210) 824-0771

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• JEFFERSON PHARMACY Doing business as

Locations

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288051200000",
    "number": "1265560528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "917 MANOR DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782283227",
            "telephone_number": "210-734-5133",
            "fax_number": "210-735-8815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "917 MANOR DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782283227",
            "telephone_number": "210-734-5133",
            "fax_number": "210-735-8815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFERSON PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-01",
        "last_updated": "2010-10-26",
        "status": "A",
        "authorized_official_last_name": "KENNEDY",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "210-824-0771"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TX",
            "license": "06118",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "4530487",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "144858",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "JEFFERSON PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kamryn Jefferies
• Lauren Brooke Jefferies, LPC
• John Jeffers, LPC
• Jefferson Family Practice
• Jefferson Medical Supply, Inc.
• Devon Jefferson, LCSW
• Jeffery L. Miller, DDS, Inc (24th Street Dental Care)
• Takarah Kide Jeffery
• Leticia G Jeffords, DDS
• Jeffrey a. Feinstein, M.D., P.a.

• Community/Retail Pharmacy in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Community/Retail Pharmacy in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2010; 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.