Jared Jeffrey
Individual provider Active NPI Pharmacist · Pineville, KY
NPI 1700280641 · NPPES record last updated Oct 21, 2014
Key facts
- NPI
- 1700280641
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 017050 (KY)
- Practice address
- 528 W Tennessee Ave
Pineville, KY 40977-1437 - Phone
- (606) 337-1444
- NPI assigned
- Oct 21, 2014
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 017050 | KY | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 017050 | KY | Yes |
Addresses
Primary practice location
528 W Tennessee Ave
Pineville, KY 40977-1437
Mailing address
528 W Tennessee Ave
Pineville, KY 40977-1437
Phone (606) 337-1444
Other providers in Pineville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 21, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.