NPIMap

Organization Active NPI

Jordan Drug, Inc.

Doing business as Village Apothecary

  • Community/Retail Pharmacy
  • Beattyville, KY
National Provider Identifier
1740216241
Registry record updated Jul 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
P01327 Issued in KY
Legal business name
JORDAN DRUG, INC.
Doing business as
Village Apothecary
Practice address
1075 Highway 11 N
Beattyville, KY 41311-9240
Phone
(606) 464-3656
Fax
(606) 464-9002
NPI assigned
Jun 25, 2006
Last updated
Jul 20, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2022

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 P01327 KY Primary

Addresses

Primary practice location

1075 Highway 11 N
Beattyville, KY 41311-9240

Mailing address

PO Box 346
Beattyville, KY 41311-0346
Phone (606) 464-3656

Other identifiers 3

IdentifierTypeStateIssuer
FLU0298OtherKYMEDICARE FLU
9006065800OtherKYDME MEDICAID
5403200800MedicaidKY

Other names 1

  • Village Apothecary Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930077656 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.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1151193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658275200000",
    "number": "1740216241",
    "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": "606-464-3656",
            "fax_number": "606-464-9002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1075 HIGHWAY 11 N",
            "city": "BEATTYVILLE",
            "state": "KY",
            "postal_code": "413119240",
            "telephone_number": "606-464-3656",
            "fax_number": "606-464-9002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JORDAN DRUG, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-25",
        "last_updated": "2022-07-20",
        "certification_date": "2022-07-20",
        "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": "P01327",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE FLU",
            "identifier": "FLU0298",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DME MEDICAID",
            "identifier": "9006065800",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5403200800",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Village Apothecary",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Village Apothecary",
            "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 Jul 20, 2022; 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.