JACKSONVILLE PHARMACY LLC NPI 1407022700

NPI Information

  • NPI: 1407022700
  • Provider Name: JACKSONVILLE PHARMACY LLC
  • Classification: Pharmacy - 333600000X
  • Entity Type: Organization
  • Address: 725 N 5TH ST STE 100
    JACKSONVILLE, OR
    ZIP 97530
  • Phone: (541) 899-7948

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NPI Details

JACKSONVILLE PHARMACY LLC is a pharmacy in Jacksonville, OR. The provider is a facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. JACKSONVILLE PHARMACY LLC NPI is 1407022700. The provider is registered as an organization entity type.

The provider's business location address is:

725 N 5TH ST STE 100
JACKSONVILLE, OR
ZIP 97530-874
Phone: (541) 899-7948
Fax: (541) 899-7946

The provider's authorized official is James Ken Johnson .
The authorized official title is Owner and has the following contact phone number (541) 899-7948.

The enumeration date for this NPI number is 5/6/2008 and was last updated on 5/6/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1333600000XPharmacyRP002114CSOREGONYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1275501MEDICAIDOREGON
24957150001MEDICARE NSCOREGON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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