Jims Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

114602 Issued in AL

Legal business name

JIMS PHARMACY LLC

Doing business as

Jim's Pharmacy at the Lake

Practice address

6378 Highway 49 S
Dadeville, AL 36853-6727

Phone

(256) 373-3449

Fax

(256) 373-3359

NPI assigned

Mar 9, 2016

Last updated

Nov 14, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jim Clanton

Title

Owner

Phone

(205) 310-9278

Specialties & licenses 4

Addresses

Other identifiers 1

Other names 1

• Jim's Pharmacy at the Lake Doing business as

Locations

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

{
    "created_epoch": "1457481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605312000000",
    "number": "1881055564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6378 HIGHWAY 49 S",
            "city": "DADEVILLE",
            "state": "AL",
            "postal_code": "368536727",
            "telephone_number": "256-373-3449",
            "fax_number": "256-373-3359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6378 HIGHWAY 49 S",
            "city": "DADEVILLE",
            "state": "AL",
            "postal_code": "368536727",
            "telephone_number": "256-373-3449",
            "fax_number": "256-373-3359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JIMS PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-09",
        "last_updated": "2020-11-14",
        "certification_date": "2020-11-14",
        "status": "A",
        "authorized_official_last_name": "CLANTON",
        "authorized_official_first_name": "JIM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "205-310-9278"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "AL",
            "license": "114602",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2158847",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jim's Pharmacy at the Lake",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Jim's Pharmacy at the Lake",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Dadeville, AL
• Providers in Dadeville, AL by specialty
• Community/Retail Pharmacy in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 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.