Jacksonville Natural Health Pharmacy

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

RP-0002577-CS Issued in OR

Legal business name

JACKSONVILLE NATURAL HEALTH PHARMACY

Practice address

310 E California St
Jacksonville, OR 97530-9414

Phone

(541) 702-2700

Fax

(541) 702-2704

NPI assigned

Nov 25, 2009

Organization subpart

No

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

Authorized official

Name

Tyler Fitzsimons Fitzsimons

Title

Manager

Phone

(541) 419-1277

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Jacksonville Natural Health Pharmacy LLC Doing business as

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

{
    "created_epoch": "1259107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1259107200000",
    "number": "1992033245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 610",
            "city": "JACKSONVILLE",
            "state": "OR",
            "postal_code": "975300610",
            "telephone_number": "541-702-2700",
            "fax_number": "541-702-2704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 E CALIFORNIA ST",
            "city": "JACKSONVILLE",
            "state": "OR",
            "postal_code": "975309414",
            "telephone_number": "541-702-2700",
            "fax_number": "541-702-2704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSONVILLE NATURAL HEALTH PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-25",
        "last_updated": "2009-11-25",
        "status": "A",
        "authorized_official_last_name": "FITZSIMONS",
        "authorized_official_first_name": "TYLER FITZSIMONS",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "541-419-1277"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OR",
            "license": "RP-0002577-CS",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "3843720",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jacksonville Natural Health Pharmacy LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Jacksonville, OR
• Providers in Jacksonville, OR by specialty
• Community/Retail Pharmacy in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2009; 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.