Jelks Family Pharmacy, LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

JELKS FAMILY PHARMACY, LLC

Doing business as

Jelks Family Pharmacy

Practice address

1404 Academy St
Centreville, MS 39631

Phone

(601) 890-6001

Fax

(601) 890-6002

NPI assigned

Aug 15, 2019

Last updated

Jan 22, 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

Ashlee JelksNPI 1952995565

Title

Pharmacists

Phone

(225) 719-1987

Specialties & licenses 1

Addresses

Other names 1

• Jelks Family Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Tax ID family

Jelks Family Pharmacy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Jelks Family Pharmacy, LLC

  dba Jelks Family Pharmacy (LTC)

  • Long Term Care Pharmacy
  • Centreville, MS
  • NPI 1912741281
  NPD tax ID

Locations

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.

• Ashlee Jelks

  • Pharmacist
  • Centreville, MS
  • NPI 1952995565
  NPD Authorized official

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

{
    "created_epoch": "1565827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579651200000",
    "number": "1972159994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1016 MAGNOLIA DR",
            "city": "CENTREVILLE",
            "state": "MS",
            "postal_code": "396314173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1404 ACADEMY ST",
            "city": "CENTREVILLE",
            "state": "MS",
            "postal_code": "39631",
            "telephone_number": "601-890-6001",
            "fax_number": "601-890-6002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JELKS FAMILY PHARMACY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-15",
        "last_updated": "2020-01-22",
        "certification_date": "2020-01-22",
        "status": "A",
        "authorized_official_last_name": "JELKS",
        "authorized_official_first_name": "ASHLEE",
        "authorized_official_title_or_position": "PHARMACISTS",
        "authorized_official_telephone_number": "225-719-1987"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jelks Family Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Jelks Family Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Amber Smith Flowers, FNP-C
• Gemini Emergency Physicians, LLC
• James Hawley, NP-C
• Kathleen Rouprich Huff, PA-C
• Jelks Family Pharmacy, LLC (Jelks Family Pharmacy (LTC))
• Ashlee Jelks
• James L. Jelks Jr., R. PH.
• Caroline Agatha Lobrano
• Thomas E Lobrano Sr., DDS
• Samantha Magee, FNP

• Community/Retail Pharmacy in Centreville, MS
• Providers in Centreville, MS by specialty
• Community/Retail Pharmacy in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2020; 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.