=====================================================
General NPI Number Information
=====================================================
NPI Number | 1730026584
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JEFFERSON PHARMACY INC LTC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/30/2026
-----------------------------------------------------
Last Update Date | 04/30/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 201 S PRESTON ST
-----------------------------------------------------
City | RANSON
-----------------------------------------------------
State | WV
-----------------------------------------------------
Zip | 25438-1676
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 304-725-6533
-----------------------------------------------------
Fax | 304-725-4330
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 201 S PRESTON ST
-----------------------------------------------------
City | RANSON
-----------------------------------------------------
State | WV
-----------------------------------------------------
Zip | 25438-1676
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 304-725-6533
-----------------------------------------------------
Fax | 304-725-4330
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | JAMES SCOTT BOYD
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 304-229-3879
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3336L0003X
-----------------------------------------------------
Taxonomy Name | Long Term Care Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------