Jacksonville Pharmacy LLC

Primary specialty

PharmacyTaxonomy code 333600000X

License

RP002114CS Issued in OR

Legal business name

JACKSONVILLE PHARMACY LLC

Practice address

725 N 5TH St Ste 100
Jacksonville, OR 97530-9874

Phone

(541) 899-7948

Fax

(541) 899-7946

NPI assigned

May 6, 2008

Organization subpart

No

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

Authorized official

Name

James Ken Johnson, RPHNPI 1831107879

Title

Owner

Phone

(541) 899-7948

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

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

• James Kenneth Johnson, R.PH.

  • Pharmacist
  • Jacksonville, OR
  • NPI 1831107879
  NPD (past) Authorized official

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

{
    "created_epoch": "1210032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210032000000",
    "number": "1407022700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 N 5TH ST STE 100",
            "city": "JACKSONVILLE",
            "state": "OR",
            "postal_code": "975309874",
            "telephone_number": "541-899-7948",
            "fax_number": "541-899-7946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 N 5TH ST STE 100",
            "city": "JACKSONVILLE",
            "state": "OR",
            "postal_code": "975309874",
            "telephone_number": "541-899-7948",
            "fax_number": "541-899-7946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSONVILLE PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-06",
        "last_updated": "2008-05-06",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "KEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-899-7948",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "OR",
            "license": "RP002114CS",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "275501",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jay Hutsell
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• Jacksonville Chiropractic Clinic LLC
• Jacksonville Natural Health Pharmacy
• Jacksonville Pharmacy, Inc.
• Jacksonville Vision Clinic Inc
• James Kenneth Johnson, R.PH.
• Yael Jones
• Owen David Jurling, LAC

• Pharmacy in Jacksonville, OR
• Providers in Jacksonville, OR by specialty
• Pharmacy in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2008; 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.