Organization Active NPI

LJB Inc

Doing business as Jeffs Prescription Shop

  • Pharmacy
  • Elizabethtown, KY
National Provider Identifier
1447330675
Registry record updated Oct 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
LJB INC
Doing business as
Jeffs Prescription Shop
Practice address
2415 Ring Rd
Elizabethtown, KY 42701
Phone
(270) 765-2157
Fax
(270) 765-2357
NPI assigned
Oct 16, 2006
Last updated
Oct 25, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2022

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

Authorized official

Name
Kent F. Williams, PHARMDNPI 1275603128
Title
Pharmacist/Owner
Phone
(270) 765-3335

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X NU Primary

Addresses

Primary practice location

2415 Ring Rd
Elizabethtown, KY 42701

Mailing address

2415 Ring Rd
Elizabethtown, KY 42701-7941
Phone (270) 765-2157

Other identifiers 4

IdentifierTypeStateIssuer
1801934OtherNCPDP
9013047700OtherKYKYDME
P08023OtherKYPHARMACY LICENSE
54002373MedicaidKY

Other names 1

  • Jeffs Prescription Shop Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20080422000485 KY Part B Supplier - Mass Immunization (Roster Biller Only) 4981782612 Practice locations: Elizabethtown, KY
O20100930026528 KY DME Supplier - Pharmacy 4981782612 Practice locations: Elizabethtown, KY

National Provider Directory

National Provider Directory
Tax ID family
Jeff's LTC Pharmacy2 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.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666656000000",
    "number": "1447330675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2415 RING RD",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427017941",
            "telephone_number": "270-765-2157",
            "fax_number": "270-765-2357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2415 RING RD",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "42701",
            "telephone_number": "270-765-2157",
            "fax_number": "270-765-2357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LJB INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-16",
        "last_updated": "2022-10-25",
        "certification_date": "2022-10-25",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "KENT",
        "authorized_official_middle_name": "F.",
        "authorized_official_title_or_position": "PHARMACIST/OWNER",
        "authorized_official_telephone_number": "270-765-3335",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "1801934",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KYDME",
            "identifier": "9013047700",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACY LICENSE",
            "identifier": "P08023",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "54002373",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jeffs Prescription Shop",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Jeffs Prescription Shop",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Elizabethtown, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2022; 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.