Jen&Josh Inc
Organization Active NPI Community/Retail Pharmacy · Dierks, AR
NPI 1497766604 · NPPES record last updated Oct 19, 2022
Key facts
- NPI
- 1497766604
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- AR16330 (AR)
- Legal business name
- JEN&JOSH INC
- Practice address
- 323 Main St
Dierks, AR 71833-0140 - Phone
- (870) 286-3131
- Fax
- (870) 286-2547
- NPI assigned
- Aug 11, 2006
- Organization subpart
- No
Authorized official
- Name
- Jennifer Jones
- Title
- President
- Phone
- (870) 285-3309
Practitioners 1
-
Jennifer Leigh Jones, PHARM.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in AR
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20151210000550 | AR | Part B Supplier - Pharmacy | 0547561847 | Practice locations: Dierks, AR |
| O20201210002905 | AR | Part B Supplier - Mass Immunization (Roster Biller Only) | 0547561847 | Practice locations: Dierks, AR |
National Provider Directory
Locations
323 Main Ave
Dierks, AR 71833
Phone (870) 286-3131
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | AR16330 | AR | Yes |
| Long Term Care Pharmacy | 3336L0003X |
Addresses
Primary practice location
323 Main St
Dierks, AR 71833-0140
Mailing address
PO Box 69
Dierks, AR 71833-0069
Phone (870) 286-3131
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 208506407 | Medicaid | AR | |
| 2151012 | Other | PK |
Other names
- Dierks Pharmacy
Other providers in Dierks, AR
- Hannah Nicole Ellis
- Priscilla Ann Faulkner
- Shelby Gail Foshee
- Robert Ernest Gunter
- Impact Counseling Clinic, Incorporated
- Jennifer Leigh Jones
- Lansdell Family Clinic PLLC
- Nita Moore
- Breanna Nicole Mounts
- Veronica Ozura
All providers in Dierks, AR · Community/Retail Pharmacy in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 19, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.