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General NPI Number Information
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NPI Number | 1245196898
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Entity Type | Organization
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Legal Business Name | JEFFERSON COUNTY HEALTH CENTER RETAIL PHARMACY
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Dates
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Enumeration Date | 12/29/2025
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Last Update Date | 12/29/2025
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Provider Practice Location Address
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Address Line | 2000 S MAIN ST
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City | FAIRFIELD
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State | IA
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Zip | 52556-9572
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Country | US
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Telephone | 641-469-4304
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Fax |
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Provider Business Mailing Address
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Address Line | 2000 S MAIN ST
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City | FAIRFIELD
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State | IA
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Zip | 52556-9572
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Country | US
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Telephone | 641-469-4304
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Fax |
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | MR. BRENT FEICKERT
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Credential |
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Telephone | 641-469-4304
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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