NPIMap

Organization Active NPI

Jaysix Enterprises LLC

  • Community/Retail Pharmacy
  • Albuquerque, NM
National Provider Identifier
1669579595
Registry record updated Aug 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
JAYSIX ENTERPRISES LLC
Practice address
7120 Wyoming Blvd NE
Ste 7B
Albuquerque, NM 87109-4887
Phone
(505) 346-0533
Fax
(505) 346-0532
NPI assigned
Sep 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2019

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

Authorized official

Name
John ArnettNPI 1730376401
Title
Owner
Phone
(505) 346-0533

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

7120 Wyoming Blvd NE
Ste 7B
Albuquerque, NM 87109-4887

Mailing address

7120 Wyoming Blvd NE
Ste 7B
Albuquerque, NM 87109-4887

Other identifiers 2

IdentifierTypeStateIssuer
78726271MedicaidNM
3207861OtherOTHER ID NUMBER-COMMERCIAL NUMBER

Other names 1

  • Sam's Regent Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191008000513 NM Part B Supplier - Mass Immunization (Roster Biller Only) 5991036808 Practice locations: Albuquerque, NM

National Provider Directory

National Provider Directory

Locations

7120 Wyoming Blvd NE
Ste 6
Albuquerque, NM 87109
Phone (505) 346-0533

7120 Wyoming Blvd NE
Ste 7B
Albuquerque, NM 87109
Phone (505) 346-0533

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1566777600000",
    "number": "1669579595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7120 WYOMING BLVD NE",
            "address_2": "STE 7B",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871094887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7120 WYOMING BLVD NE",
            "address_2": "STE 7B",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871094887",
            "telephone_number": "505-346-0533",
            "fax_number": "505-346-0532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAYSIX ENTERPRISES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2019-08-26",
        "status": "A",
        "authorized_official_last_name": "ARNETT",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "505-346-0533"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "78726271",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "3207861",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sam's Regent Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.