Jjel,LLC

Primary specialty

Clinic PharmacyTaxonomy code 3336C0002X

Legal business name

JJEL,LLC

Doing business as

Valley Drug

Practice address

1500 Curve Crest Blvd W
Stillwater, MN 55082-6040

Phone

(651) 430-4670

Fax

(651) 430-4671

NPI assigned

Mar 5, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Jim Polucha, PHARM.D, BSPHARM

Title

Owner/President/Pharmacist

Phone

(651) 430-4670

Specialties & licenses 1

Addresses

Other names 1

• Valley Drug Doing business as

Electronic endpoints 1

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

{
    "created_epoch": "1583366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583366400000",
    "number": "1619502168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12508 JODY AVE N",
            "city": "HUGO",
            "state": "MN",
            "postal_code": "550389419",
            "telephone_number": "651-439-2825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 CURVE CREST BLVD W",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550826040",
            "telephone_number": "651-430-4670",
            "fax_number": "651-430-4671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JJEL,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-05",
        "last_updated": "2020-03-05",
        "certification_date": "2020-03-05",
        "status": "A",
        "authorized_official_last_name": "POLUCHA",
        "authorized_official_first_name": "JIM",
        "authorized_official_title_or_position": "OWNER/PRESIDENT/PHARMACIST",
        "authorized_official_telephone_number": "651-430-4670",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARM.D, BSPHARM"
    },
    "taxonomies": [
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "myvalleydrug.com",
            "affiliation": "N",
            "endpointDescription": "website",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Hugo",
            "address_1": "1500 Curve Crest Blvd W",
            "city": "Stillwater",
            "state": "MN",
            "country_code": "US",
            "postal_code": "550826040",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Valley Drug",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Cortney Lynn Jarvey
• Rebecca Jennings, PA
• Sara Joan Jennisch, MSN, CNP, AGNP-C
• Emily Lynn Jensen
• Joel Bruce Jensen, MD
• John F. Reardon DDS, PA
• Carla Rae Johnson, CNP
• Daniel Theodore Johnson Jr., DDS
• Danielle Renee Johnson
• Jordan Lee Johnson, MA, LPC, LPCC

• Clinic Pharmacy in Stillwater, MN
• Providers in Stillwater, MN by specialty
• Clinic Pharmacy in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2020; 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.