Organization
JEFFERSON PHARMACY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SCOTT BOYD (PRES)
(304) 725-6533
Entity
Organization
Contact information
Practice address
201 S PRESTON ST, RANSON, WV 25438-1628
(304) 725-6533
(304) 725-4330
Mailing address
201 S PRESTON ST, RANSON, WV 25438-1628
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
—
—
333600000X
Pharmacy
Primary
SP0550835
WV
3336C0003X
Community/Retail Pharmacy
—
—
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0143416000
—
WV
01
—
5007085
OTHER ID NUMBER
—
Enumeration date
08/01/2005
Last updated
07/03/2023
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