Jerry L Philmon

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

00859 Issued in TX

Legal business name

JERRY L PHILMON

Practice address

5897 W Port Arthur Rd
Port Arthur, TX 77640-1754

Phone

(409) 736-2277

Fax

(409) 736-2854

NPI assigned

Aug 18, 2006

Organization subpart

No

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

Authorized official

Name

Orville Odom

Title

Partner

Phone

(409) 736-2277

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• ALFORDS PHARMACY Doing business as

Locations

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263427200000",
    "number": "1609980697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5428",
            "city": "PORT ARTHUR",
            "state": "TX",
            "postal_code": "776400428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5897 W PORT ARTHUR RD",
            "city": "PORT ARTHUR",
            "state": "TX",
            "postal_code": "776401754",
            "telephone_number": "409-736-2277",
            "fax_number": "409-736-2854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JERRY L PHILMON",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-18",
        "last_updated": "2010-01-14",
        "status": "A",
        "authorized_official_last_name": "ODOM",
        "authorized_official_first_name": "ORVILLE",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "409-736-2277"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TX",
            "license": "00859",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "140074",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "4537936",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ALFORDS PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jefferson County Adult Day Center
• Jefferson County Adult Day Center
• Jefferson County Day Activity & Health Service Center
• Jennifer Lewis
• June Lynette Jennings, LVN
• Fareesha Jiwani, PA
• John a Iceton MD PA
• John H. Lee DO, PA
• Connie Denise Johnson-Wiltz, FNP-BC
• Cathy A Johnson

• Community/Retail Pharmacy in Port Arthur, TX
• Providers in Port Arthur, TX by specialty
• Community/Retail Pharmacy in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2010; 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.