Ernest Knight Drugs, Inc
Organization Active NPI Pharmacy · Jesup, GA
NPI 1689624082 · NPPES record last updated Mar 20, 2017
Key facts
- NPI
- 1689624082
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pharmacy 333600000X
- License
- PHRE000255 (GA)
- Legal business name
- ERNEST KNIGHT DRUGS, INC
- Practice address
- 149 N.W. Broad St.
Jesup, GA 31545 - Phone
- (912) 427-3726
- Fax
- (912) 427-8788
- NPI assigned
- May 10, 2006
- Organization subpart
- No
Authorized official
- Name
- Mr. Alan Millard Jones, R.PH.
- Title
- President
- Phone
- (912) 427-3726
Practitioners 3
-
Alan Millard Jones, R.PH.
-
Misty J Juarbe, RPH
-
Danna Metts Harvey, PHARMD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100901000454 | GA | Part B Supplier - Mass Immunization (Roster Biller Only) | 8820112568 | Practice locations: Jesup, GA |
National Provider Directory
Locations
106 E Cherry St
Jesup, GA 31546
Phone (912) 427-2254
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | PHRE000255 | GA | Yes |
Addresses
Primary practice location
149 N.W. Broad St.
Jesup, GA 31545
Mailing address
149 N.W. Broad St.
Jesup, GA 31545
Phone (912) 427-3726
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00030093B | Medicaid | GA |
Other names
- JONES DRUG COMPANY
NPI Registry JSON
{
"created_epoch": "1147219200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1489968000000",
"number": "1689624082",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "149 N.W. BROAD ST.",
"city": "JESUP",
"state": "GA",
"postal_code": "31545",
"telephone_number": "912-427-3726",
"fax_number": "912-427-8788"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "149 N.W. BROAD ST.",
"city": "JESUP",
"state": "GA",
"postal_code": "31545",
"telephone_number": "912-427-3726",
"fax_number": "912-427-8788"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ERNEST KNIGHT DRUGS, INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-05-10",
"last_updated": "2017-03-20",
"status": "A",
"authorized_official_last_name": "JONES",
"authorized_official_first_name": "ALAN",
"authorized_official_middle_name": "MILLARD",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "912-427-3726",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "R.PH."
},
"taxonomies": [
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": "GA",
"license": "PHRE000255",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00030093B",
"state": "GA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "JONES DRUG COMPANY",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Jesup, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 20, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.