Jefferson RX LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

530101816 Issued in MI

Legal business name

JEFFERSON RX LLC

Doing business as

Knight Drugs - Jefferson

Practice address

8367 E Jefferson Ave
Detroit, MI 48214-2730

Phone

(313) 925-7890

Fax

(313) 925-7889

NPI assigned

Nov 2, 2017

Last updated

Sep 20, 2023By the provider in NPPES

Organization subpart

Yes

Parent organization

JEFFERSON MANAGEMENT INCAs reported in NPPES

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

Authorized official

Name

Candice Tolf

Title

3Rd Party Coordinator

Phone

(313) 751-7979

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Knight Drugs - Jefferson Doing business as

Locations

Practitioners 2

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.

• Imad Y Aoun

  • Pharmacist
  • Detroit, MI
  • NPI 1427148063
  NPD (past)
• Rick Vestich, RPH

  • Pharmacist
  • Detroit, MI
  • NPI 1235722885
  NPD (past)

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

{
    "created_epoch": "1509580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695168000000",
    "number": "1740792449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6689 ORCHARD LAKE RD STE 168",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483223404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8367 E JEFFERSON AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482142730",
            "telephone_number": "313-925-7890",
            "fax_number": "313-925-7889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFERSON RX LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "JEFFERSON MANAGEMENT INC",
        "enumeration_date": "2017-11-02",
        "last_updated": "2023-09-20",
        "certification_date": "2023-09-20",
        "status": "A",
        "authorized_official_last_name": "TOLF",
        "authorized_official_first_name": "CANDICE",
        "authorized_official_title_or_position": "3RD PARTY COORDINATOR",
        "authorized_official_telephone_number": "313-751-7979"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "530101816",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLEXSCRIPT",
            "identifier": "FSRX5585884",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Knight Drugs - Jefferson",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Maggie Jedlinsky, LLMSW
• Yoonsun Jee
• Madana Jeevanandam, M.D.
• Cynthia Jefferson Lane, LMSW, SSW
• Jefferson Medical Industrial Clinic PC
• Alyce L Jefferson
• Candace Jefferson
• Jasmine Shanice Jefferson
• Kelly Daneil-Marie Jefferson, BS
• Klyn Jefferson

• Community/Retail Pharmacy in Detroit, MI
• Providers in Detroit, MI by specialty
• Community/Retail Pharmacy in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.