NPI Database
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Contact Information

JEFFERSON PHARMACY
194 TURKEYSAG TRL STE B
PALMYRA, VA22963-2661
 Phone: 434-589-7902
 Fax: 434-589-7912
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
 

Compounding Pharmacy

3336C0004X 58 Medical Supply Company with Pharmacist
 

Durable Medical Equipment & Medical Supplies

332B00000X 54 Other Medical Supply Company
 

Pharmacy

333600000X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for JEFFERSON PHARMACY

NPI # 1871731448
LBN Legal business name JEFFERSON PHARMACY
Authorized official KELLY OLIVER - (PIC)
Entity Organization
Organization subpart 1 No
Enumeration date 02/04/2009
Last updated 04/07/2017 - About 9 years ago
Identifiers
VA License # 0201004268
VA Medicaid 1871731448
Other 2118991 PK
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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