Provider Demographics
NPI:1891772463
Name:JONES LTC PHARMACY, INC.
Entity Type:Organization
Organization Name:JONES LTC PHARMACY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:PEARMAN
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:434-634-2639
Mailing Address - Street 1:321 OAK HILL DR
Mailing Address - Street 2:
Mailing Address - City:EMPORIA
Mailing Address - State:VA
Mailing Address - Zip Code:23847-2420
Mailing Address - Country:US
Mailing Address - Phone:434-348-4987
Mailing Address - Fax:434-348-4558
Practice Address - Street 1:306A WEAVER AVE
Practice Address - Street 2:
Practice Address - City:EMPORIA
Practice Address - State:VA
Practice Address - Zip Code:23847-1232
Practice Address - Country:US
Practice Address - Phone:434-348-4987
Practice Address - Fax:434-348-4558
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-27
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA02010037823336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
4836841OtherNABP
NC0497402Medicaid
0201003782OtherVA LICENSE
BJ7585839OtherDEA