NPIMap

Organization Active NPI

Jay's Roadhouse and Pharmacy, LLC

Doing business as Lyons LTC

  • Long Term Care Pharmacy
  • Steamboat Springs, CO
National Provider Identifier
1851939805
Registry record updated Oct 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
Legal business name
JAY'S ROADHOUSE AND PHARMACY, LLC
Doing business as
Lyons LTC
Practice address
840 Lincoln Ave
Steamboat Springs, CO 80487-5005
Phone
(970) 879-1115
Fax
(970) 879-5643
NPI assigned
Dec 19, 2019
Organization subpart
Yes
Parent organization
JAY'S ROADHOUSE AND PHARMACY LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 21, 2020

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

Authorized official

Name
Dr. Matthew Todd Johnson, PHARM.D.
Title
Pharmacist/Owner
Phone
(970) 879-1114

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Pharmacy 3336L0003X Primary

Addresses

Primary practice location

840 Lincoln Ave
Steamboat Springs, CO 80487-5005

Mailing address

840 Lincoln Ave
Steamboat Springs, CO 80487-5005
Phone (970) 879-1115

Other names 1

  • Lyons LTC Doing business as

National Provider Directory

National Provider Directory
Part of
Jays Roadhouse and Pharmacy

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1576713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603238400000",
    "number": "1851939805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 LINCOLN AVE",
            "city": "STEAMBOAT SPRINGS",
            "state": "CO",
            "postal_code": "804875005",
            "telephone_number": "970-879-1115",
            "fax_number": "970-879-5643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 LINCOLN AVE",
            "city": "STEAMBOAT SPRINGS",
            "state": "CO",
            "postal_code": "804875005",
            "telephone_number": "970-879-1115",
            "fax_number": "970-879-5643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAY'S ROADHOUSE AND PHARMACY, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "JAY'S ROADHOUSE AND PHARMACY LLC",
        "enumeration_date": "2019-12-19",
        "last_updated": "2020-10-21",
        "certification_date": "2020-10-21",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "TODD",
        "authorized_official_title_or_position": "PHARMACIST/OWNER",
        "authorized_official_telephone_number": "970-879-1114",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARM.D."
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lyons LTC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Lyons LTC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Steamboat Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2020; 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.