NPIMap

Organization Active NPI

Jordan Drug, Inc.

  • Community/Retail Pharmacy
  • Clay City, KY
National Provider Identifier
1295762987
Registry record updated May 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
P06458 Issued in KY
Legal business name
JORDAN DRUG, INC.
Practice address
4644 Highway 15 West
Clay City, KY 40312
Phone
(606) 663-3481
Fax
(606) 663-4235
NPI assigned
Jun 27, 2006
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Rosemary C Smith, R. PH.
Title
Sec/Treas
Phone
(606) 464-3901

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY2 enrollments

Medicare enrollment records 2

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
O20100930090203 KY DME Supplier - PharmacyDME Supplier - Medical Supply Company 5597764993 Practice locations: Clay City, KY
O20150702001929 KY Part B Supplier - Mass Immunization (Roster Biller Only) 5597764993 7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Booneville, KY; Jackson, KY; Clay City, KY; Campton, KY; Beattyville, KY

National Provider Directory

National Provider Directory

Specialties & licenses 3

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Parenteral & Enteral Nutrition Supplies (DME) 332BP3500X
Community/Retail Pharmacy 3336C0003X P06458 KY Primary

Addresses

NPPES NPI Registry

Primary practice location

4644 Highway 15 West
Clay City, KY 40312

Mailing address

PO Box 346
Beattyville, KY 41311-0346
Phone (606) 464-3901

Other identifiers 3

NPPES NPI Registry
IdentifierTypeStateIssuer
5403457400MedicaidKY
9000102500OtherKYDME MEDICAID
FLU0298OtherKYMEDICARE FLU

Other names 1

NPPES NPI Registry
  • Powell Prescription Center Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 8, 2009.

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1241740800000",
    "number": "1295762987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 346",
            "city": "BEATTYVILLE",
            "state": "KY",
            "postal_code": "413110346",
            "telephone_number": "606-464-3901",
            "fax_number": "606-464-8888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4644 HIGHWAY 15 WEST",
            "city": "CLAY CITY",
            "state": "KY",
            "postal_code": "40312",
            "telephone_number": "606-663-3481",
            "fax_number": "606-663-4235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JORDAN DRUG, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-27",
        "last_updated": "2009-05-08",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "ROSEMARY",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "SEC/TREAS",
        "authorized_official_telephone_number": "606-464-3901",
        "authorized_official_credential": "R. PH."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "KY",
            "license": "P06458",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5403457400",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DME MEDICAID",
            "identifier": "9000102500",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE FLU",
            "identifier": "FLU0298",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Powell Prescription Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clay City, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2009; 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.