Jr Pharmacy Rockville LLC 4

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

60005901A Issued in IN

Legal business name

JR PHARMACY ROCKVILLE LLC 4

Doing business as

JR PHARMACY ROCKVILLE LLC 4 & JR Pharmacy Rockville

Practice address

1330 N Lincoln Rd
Rockville, IN 47872-1215

Phone

(765) 569-6900

Fax

(765) 569-5797

NPI assigned

Sep 13, 2006

Last updated

Jan 22, 2026By 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

Mr. Terry J Warren

Title

President

Phone

(765) 828-1003

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• JR PHARMACY ROCKVILLE LLC 4 & JR Pharmacy Rockville Doing business as

Medicare fee-for-service enrollment

Enrolled in IN2 enrollments

Enrollment records 2

Locations

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769040000000",
    "number": "1295830578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1238 S 3RD ST STE C",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478020018",
            "telephone_number": "812-234-8305",
            "fax_number": "812-234-0225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 N LINCOLN RD",
            "city": "ROCKVILLE",
            "state": "IN",
            "postal_code": "478721215",
            "telephone_number": "765-569-6900",
            "fax_number": "765-569-5797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JR PHARMACY ROCKVILLE LLC 4",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-13",
        "last_updated": "2026-01-22",
        "certification_date": "2026-01-22",
        "status": "A",
        "authorized_official_last_name": "WARREN",
        "authorized_official_first_name": "TERRY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "765-828-1003",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IN",
            "license": "60005901A",
            "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": "200522310",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "JR PHARMACY ROCKVILLE LLC 4 & JR Pharmacy Rockville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Rockville, IN
• Providers in Rockville, IN by specialty
• Community/Retail Pharmacy in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2026; 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.