La Jara Pharmaceutical Center, Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

AL7908114 Issued in CO

Legal business name

LA JARA PHARMACEUTICAL CENTER, INC.

Practice address

412 Main Street
La Jara, CO 81140

Phone

(719) 274-5109

Fax

(719) 274-4246

NPI assigned

Oct 4, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Joseph Thomas Valdez, RPHNPI 1487267803

Title

Pharmacist Owner

Phone

(719) 274-5109

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CO2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Practitioners 3

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

• Joseph T. Valdez, R.PH

  • Pharmacist
  • La Jara, CO
  • NPI 1487267803
  NPD Authorized official
• David Charles Stuhr, PHARMACIST

  • Pharmacist
  • La Jara, CO
  • NPI 1891302592
  NPD (past)
• Christopher James Martinez, PHARMD, RPH

  • Pharmacist
  • Albuquerque, NM
  • NPI 1164831202
  NPD (past)

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492387200000",
    "number": "1346336997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "412 MAIN ST",
            "address_2": "PO BOX 609",
            "city": "LA JARA",
            "state": "CO",
            "postal_code": "81140",
            "telephone_number": "719-274-5109",
            "fax_number": "719-274-4246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 MAIN STREET",
            "city": "LA JARA",
            "state": "CO",
            "postal_code": "81140",
            "telephone_number": "719-274-5109",
            "fax_number": "719-274-4246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LA JARA PHARMACEUTICAL CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-04",
        "last_updated": "2017-04-17",
        "status": "A",
        "authorized_official_last_name": "VALDEZ",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "PHARMACIST OWNER",
        "authorized_official_telephone_number": "719-274-5109",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CO",
            "license": "AL7908114",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CO",
            "license": "AL7908114",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03498474",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NPI",
            "identifier": "1346336997",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Alfred Vaughn D Jackson, MD
• Brian Gene Jackson, PAC
• Maria Virginia Jordan, FNP
• Elizabeth B Kinney, MD
• Linda Lee I, FNP, PA
• Arthur Howard Legate, MD
• David L Lenderts, MD
• Lutheran Hospital Association of the San Luis Valley
• Lutheran Hospital Association of the San Luis Valley

• Community/Retail Pharmacy in La Jara, CO
• Providers in La Jara, CO by specialty
• Community/Retail Pharmacy in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.