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Contact Information

JORDAN DRUG, INC.
820 HWY 11 NORTH
BOONEVILLE, KY41314
 Phone: 606-593-6306
 Fax: 606-593-6859
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
 

Durable Medical Equipment & Medical Supplies

332B00000X 54 Other Medical Supply Company
 

Parenteral & Enteral Nutrition

332BP3500X 87 All Other Suppliers
Indicates primary specialty

NPI Profile & details for JORDAN DRUG, INC.

NPI Number 1205862836
LBN Legal business name JORDAN DRUG, INC.
Authorized official ROSEMARY SMITH - (SEC/TREAS)
Entity Organization
Organization subpart 1 No
Enumeration date 06/24/2006
Last updated 09/21/2015 - About 11 years ago
Identifiers
KY License # P01464
KY Medicaid 5403203200
KY Other 9003095800 DME MEDICAID
KY Other FLU0298 MEDICARE FLU
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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