Jones Drug Store Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

005586 Issued in MO

Legal business name

JONES DRUG STORE INC

Practice address

125 Court Street
Jackson, MO 63755

Phone

(573) 243-3524

Fax

(573) 243-2155

NPI assigned

Sep 1, 2006

Last updated

Apr 29, 2019By 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

Mr. Bryan Thomas Kiefer, RPH

Title

Manager / Pic

Phone

(573) 243-3525

Specialties & licenses 4

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Locations

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

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1556496000000",
    "number": "1891897815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 494",
            "address_2": "125 COURT STREET",
            "city": "JACKSON",
            "state": "MO",
            "postal_code": "63755",
            "telephone_number": "573-243-3524",
            "fax_number": "573-243-2155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 COURT STREET",
            "city": "JACKSON",
            "state": "MO",
            "postal_code": "63755",
            "telephone_number": "573-243-3524",
            "fax_number": "573-243-2155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JONES DRUG STORE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-01",
        "last_updated": "2019-04-29",
        "status": "A",
        "authorized_official_last_name": "KIEFER",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "MANAGER / PIC",
        "authorized_official_telephone_number": "573-243-3525",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MO",
            "license": "10119701",
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MO",
            "license": "10119701",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MO",
            "license": "005586",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "MO",
            "license": "005586",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "600130504",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "620130500",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jackson R-2 Schools
• Stephanie Jansen, DC
• Dwight Hood Johnson, D.D.S.
• Jones Drug Store Inc
• Jones Drug Store Inc
• Abigail Renae Kasten, DPT
• Kelsey Leeann Kasten
• Elise Keele
• Alison Keiper
• Allison Keith

• Community/Retail Pharmacy in Jackson, MO
• Providers in Jackson, MO by specialty
• Community/Retail Pharmacy in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2019; 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.