Judys Drug Store Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

SP0550070 Issued in WV

Legal business name

JUDYS DRUG STORE INC

Practice address

24 N Main St
Petersburg, WV 26847-1518

Phone

(304) 257-1044

Fax

(304) 257-2681

NPI assigned

Jun 13, 2005

Organization subpart

No

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

Authorized official

Name

Emily Judy, PHARMD

Title

President

Phone

(304) 257-1044

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• JUDYS DRUG STORE INC Doing business as

Medicare fee-for-service enrollment

Enrolled in WV2 enrollments

Enrollment records 2

Tax ID family

Judys Drug Store2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Judys Drug Store Inc

  • Long Term Care Pharmacy
  • Petersburg, WV
  • NPI 1487351714
  NPD tax ID

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

{
    "created_epoch": "1118620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487116800000",
    "number": "1295739654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 N MAIN ST",
            "city": "PETERSBURG",
            "state": "WV",
            "postal_code": "268471518",
            "telephone_number": "304-257-1044",
            "fax_number": "304-257-2681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 N MAIN ST",
            "city": "PETERSBURG",
            "state": "WV",
            "postal_code": "268471518",
            "telephone_number": "304-257-1044",
            "fax_number": "304-257-2681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUDYS DRUG STORE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-13",
        "last_updated": "2017-02-15",
        "status": "A",
        "authorized_official_last_name": "JUDY",
        "authorized_official_first_name": "EMILY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "304-257-1044",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WV",
            "license": "SP0550070",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0141999000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2109313",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "JUDYS DRUG STORE INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sharita Nicolle Johnson, M.D
• Sibhan Leeann Johnson
• Terry Johnson
• Marie Wilberte Jose
• Emily C Judy, RPH
• Judys Drug Store Inc
• Judys Drug Store Inc
• Randall Scott Junkins, PHARMD
• Manassa V Kauffman
• Elsie V Keplinger

• Community/Retail Pharmacy in Petersburg, WV
• Providers in Petersburg, WV by specialty
• Community/Retail Pharmacy in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.