NPIMap

Organization Active NPI

Jordan Drug, Inc.

Doing business as Stufflebean Pharmacy

  • Community/Retail Pharmacy
  • Beattyville, KY
National Provider Identifier
1689602799
Registry record updated May 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
P01910 Issued in KY
Legal business name
JORDAN DRUG, INC.
Doing business as
Stufflebean Pharmacy
Practice address
1031 Grand Ave.
Beattyville, KY 41311
Phone
(606) 464-3396
Fax
(606) 464-0558
NPI assigned
Jun 29, 2006
Last updated
May 8, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 8, 2009

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

Authorized official

Name
Rosemary C Smith, R.PH.NPI 1568694933
Title
Sec/Treas
Phone
(606) 464-3901

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU
Parenteral & Enteral Nutrition Supplies (DME) 332BP3500X NU
Community/Retail Pharmacy 3336C0003X P01910 KY Primary

Addresses

Primary practice location

1031 Grand Ave.
Beattyville, KY 41311

Mailing address

PO Box 346
Beattyville, KY 41311-0346
Phone (606) 464-3901

Other identifiers 3

IdentifierTypeStateIssuer
FLU0298OtherKYMEDICARE FLU
5403201600MedicaidKY
9005065900OtherKYDME MEDICAID

Other names 1

  • Stufflebean Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930014713 KY DME Supplier - PharmacyDME Supplier - Medical Supply Company 5597764993 Practice locations: Beattyville, KY
O20150702001929 KY Part B Supplier - Mass Immunization (Roster Biller Only) 5597764993 7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Booneville, KY; Jackson, KY; Clay City, KY; Campton, KY; Beattyville, KY

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Jordan Drug Inc1031 Grand Ave, Beattyville, KY 41311-9022(606) 464-3396 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order)|Canes and/or Crutches|Walkers|Surgical Dressings Accepts assignmentParticipating since Jun 8, 2015

National Provider Directory

National Provider Directory

Locations

1075 Highway 11 N
Beattyville, KY 41311
Phone (606) 464-3656

200 Mulberry St
Ste B
Booneville, KY 41314
Phone (606) 593-8300

820 Ky 11 N
Booneville, KY 41314
Phone (606) 593-6306

1112 Main St
Jackson, KY 41339
Phone (606) 666-7574

842 Highway 15 N
Jackson, KY 41339
Phone (606) 666-7060

876 Parkway Dr
Salyersville, KY 41465
Phone (606) 349-1700

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1241740800000",
    "number": "1689602799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 346",
            "city": "BEATTYVILLE",
            "state": "KY",
            "postal_code": "413110346",
            "telephone_number": "606-464-3901",
            "fax_number": "606-464-8888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1031 GRAND AVE.",
            "city": "BEATTYVILLE",
            "state": "KY",
            "postal_code": "41311",
            "telephone_number": "606-464-3396",
            "fax_number": "606-464-0558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JORDAN DRUG, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-29",
        "last_updated": "2009-05-08",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "ROSEMARY",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "SEC/TREAS",
        "authorized_official_telephone_number": "606-464-3901",
        "authorized_official_credential": "R.PH."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "KY",
            "license": "P01910",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE FLU",
            "identifier": "FLU0298",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5403201600",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DME MEDICAID",
            "identifier": "9005065900",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Stufflebean Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Beattyville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.