Provider Demographics
NPI:1982996096
Name:JC & P VENTURES PLLC
Entity Type:Organization
Organization Name:JC & P VENTURES PLLC
Other - Org Name:COMMONS COMMUNITY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO, PIC
Authorized Official - Prefix:
Authorized Official - First Name:JILL
Authorized Official - Middle Name:
Authorized Official - Last Name:RHODES
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:502-614-7325
Mailing Address - Street 1:9407 NORTON COMMONS BLVD
Mailing Address - Street 2:
Mailing Address - City:PROSPECT
Mailing Address - State:KY
Mailing Address - Zip Code:40059-7525
Mailing Address - Country:US
Mailing Address - Phone:502-614-7325
Mailing Address - Fax:502-409-7315
Practice Address - Street 1:9407 NORTON COMMONS BLVD
Practice Address - Street 2:
Practice Address - City:PROSPECT
Practice Address - State:KY
Practice Address - Zip Code:40059-7525
Practice Address - Country:US
Practice Address - Phone:502-614-7325
Practice Address - Fax:502-409-7315
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-08
Last Update Date:2015-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0004X
KYP074573336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100161810Medicaid
2130252OtherPK