Jefferson Pharmacy

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 22, 2021

Organization subpart

No

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

Authorized official

Name

Mr. Beatle Tran, PHARMD

Title

Ceo

Phone

(209) 938-9556

Specialties & licenses 1

Addresses

Other identifiers 1

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.

• Jefferson Pharmacy

  • Long Term Care Pharmacy
  • West Sacramento, CA
  • NPI 1487237103
  NPD tax ID
• Jefferson Pharmacy

  • Community/Retail Pharmacy
  • West Sacramento, CA
  • NPI 1699357335
  NPD tax ID

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

{
    "created_epoch": "1619049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619049600000",
    "number": "1528640372",
    "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": "2021-04-22",
        "last_updated": "2021-04-22",
        "certification_date": "2021-03-28",
        "status": "A",
        "authorized_official_last_name": "TRAN",
        "authorized_official_first_name": "BEATLE",
        "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
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1699846774",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anne Jakovac, LMFT
• Ashley Gabrielle Jalivay, RBT
• Chanin Amrek James Hardwick, LPCC
• Lynnee T January, D.C.
• Jefferson Pharmacy
• Jefferson Pharmacy
• Jefferson Pharmacy
• Leiaha Samantha Jeffery-Howard
• Jeremy V Johnson
• Joshua Johnson

• Long Term Care Pharmacy in West Sacramento, CA
• Providers in West Sacramento, CA by specialty
• Long Term Care Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 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.