Jacksonville Pharmacy, Inc.

Primary specialty

PharmacyTaxonomy code 333600000X

Legal business name

JACKSONVILLE PHARMACY, INC.

Practice address

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

Phone

(541) 899-7948

Fax

(541) 899-7946

NPI assigned

Apr 7, 2006

Organization subpart

No

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

Authorized official

Name

Mr. J. Ken Johnson, R.PH.

Title

President

Phone

(541) 899-7948

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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)

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

{
    "created_epoch": "1144368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210032000000",
    "number": "1457314916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 N 5TH ST",
            "address_2": "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",
            "address_2": "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, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-07",
        "last_updated": "2008-05-06",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "J.",
        "authorized_official_middle_name": "KEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "541-899-7948",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "R.PH."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "275501",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Innovative Health & Wellness LLC 2
• J-Well Pilates Rehab Studio
• Jacksonville Chiropractic Clinic LLC
• Jacksonville Natural Health Pharmacy
• Jacksonville Pharmacy LLC
• Jacksonville Vision Clinic Inc
• James Kenneth Johnson, R.PH.
• Yael Jones
• Owen David Jurling, LAC
• Daniel Kaylin, D.D.S.

• 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.