Jeffco Drug Center In Jefferson City

LBN: Mountain Valley Rx 05 Inc
Jeffco Drug Center In Jefferson City is an health care organization with primary practice located at 153 E Broadway Blvd Ste 103, Jefferson City TN 37760-2517. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Mountain Valley Rx 05 Inc can be contacted via phone (865) 471-5111, or through Kisabeth, Beau via phone (865) 388-3211.

Contact Information

Primary practice address
153 E Broadway Blvd Ste 103 Jefferson City TN 37760-2517
Phone: (865) 471-5111
Fax: (865) 471-5199
Website:
Map and Directions
Authorized official contact:
Name: Kisabeth, Beau
Phone: (865) 388-3211

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Community/Retail Pharmacy 3336C0003X 3918 Tennessee

Profile Details

NPI number 1043364490
LBN Legal business name Mountain Valley Rx 05 Inc
DBA Doing business as Jeffco Drug Center In Jefferson City
Authorized official Kisabeth, Beau
Entity Organization
Organization subpart 1 No
Enumeration date Jan 23rd, 2007
Last updated Mar 30th, 2010 - about 14 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1043364490 NPPES
Other 4437364 NCPDP PROVIDER IDENTIFICATION NUMBER

Popular Providers