1174691810 NPI number — JONES DRUG COMPANY INC

Table of content: (NPI 1174691810)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1174691810 NPI number — JONES DRUG COMPANY INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JONES DRUG COMPANY INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
REEDS COMPOUNDING PHARMACY
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1174691810
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/24/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2729 E SPEEDWAY BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TUCSON
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85716-3800
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
520-318-4421
Provider Business Mailing Address Fax Number:
520-318-1054

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2729 E SPEEDWAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TUCSON
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85716-3800
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
520-318-4421
Provider Business Practice Location Address Fax Number:
520-318-1054
Provider Enumeration Date:
12/01/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
REED
Authorized Official First Name:
THOMAS
Authorized Official Middle Name:
C
Authorized Official Title or Position:
RPH OWNER
Authorized Official Telephone Number:
520-318-4421

Provider Taxonomy Codes

  • Taxonomy code: 3336S0011X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336S0011X , with the licence number: Y02967 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 3336S0011X , with the licence number: NABP0322886 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 335E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 335E00000X , with the licence number: 0314840002 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)