NPIMap

Organization Active NPI

Jefferson Pharmacy

  • Long Term Care Pharmacy
  • West Sacramento, CA
National Provider Identifier
1487237103
Registry record updated Apr 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
Legal business name
JEFFERSON PHARMACY
Practice address
1029 Jefferson Blvd Ste a
West Sacramento, CA 95691-3389
Phone
(916) 371-2022
Fax
(916) 371-2027
NPI assigned
Apr 30, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2021

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

Authorized official

Name
Mr. Beatle T Tran, PHARMD
Title
Ceo
Phone
(209) 938-9556

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Pharmacy 3336L0003X Primary
Specialty Pharmacy 3336S0011X

Addresses

Primary practice location

1029 Jefferson Blvd Ste a
West Sacramento, CA 95691-3389

Mailing address

1029 Jefferson Blvd Ste a
West Sacramento, CA 95691-3389
Phone (916) 371-2022

National Provider Directory

National Provider Directory
Tax ID family
Jefferson Pharmacy3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1619740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619740800000",
    "number": "1487237103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1029 JEFFERSON BLVD STE A",
            "city": "WEST SACRAMENTO",
            "state": "CA",
            "postal_code": "956913389",
            "telephone_number": "916-371-2022",
            "fax_number": "916-371-2027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1029 JEFFERSON BLVD STE A",
            "city": "WEST SACRAMENTO",
            "state": "CA",
            "postal_code": "956913389",
            "telephone_number": "916-371-2022",
            "fax_number": "916-371-2027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFERSON PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-30",
        "last_updated": "2021-04-30",
        "certification_date": "2021-04-03",
        "status": "A",
        "authorized_official_last_name": "TRAN",
        "authorized_official_first_name": "BEATLE",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "209-938-9556",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2021; 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.