MEDICARE: JEFFERSON PHARMACY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	333600000X	Pharmacy
2	3336C0003X	Community/Retail Pharmacy	PHY47083	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2115818	OTHER		PK

General Provider Information

NPI Number	:	1699846774
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JEFFERSON PHARMACY

Provider Business Mailing Address
First Line	:	1029 JEFFERSON BLVD STE A
Second Line	:
City	:	WEST SACRAMENTO
State	:	CA
Zip	:	95691-3344
Country	:	US
Telephone Number	:	916-371-2022
Fax Number	:	916-371-2027

Provider Business Practice Location Address
First Line	:	1029 JEFFERSON BLVD STE A
Second Line	:
City	:	WEST SACRAMENTO
State	:	CA
Zip	:	95691-3344
Country	:	US
Telephone Number	:	916-371-2022
Fax Number	:	916-371-2027

Authorized Official
Title or Position	:	OWNER
Name	:	BEATLE TRAN
Credential	:	RPH
Telephone Number	:	916-371-2022

Provider Enumeration Date	:	11/13/2006
Last Update Date	:	03/22/2017

Similar Medicare Providers

1497832083 — DR. LYSA CHARLES MD
Practice Location Address:

2101 E JEFFERSON ST PPQA MEDICARE COMPLIANCE UNT 6 WEST , KAISER PERMANENTE MID ATLANTIC PERMANENTE MEDICAL GROUP
ROCKVILLE, MD
20852-4908

Practice Phone: 301-816-6660
Practice Fax: 301-816-6308

1821081910 — DR. BEATLE THIEN-PHUOC TRAN PHARMD
Practice Location Address:

1029 JEFFERSON BLVD , SUITE A
WEST SACRAMENTO, CA
95691-3344

Practice Phone: 916-371-2022
Practice Fax: 916-371-2027

1265590145 — DR. GORDON LEE D.D.S.
Practice Location Address:

1029 JEFFERSON BLVD STE C
WEST SACRAMENTO, CA
95691-3344

Practice Phone: 916-371-2591
Practice Fax: 916-371-0198

1801946769 — DR. MARTIN D. L. CHAN D.D.S.
Practice Location Address:

1029 JEFFERSON BLVD , STE. E
WEST SACRAMENTO, CA
95691-3344

Practice Phone: 916-371-8913
Practice Fax:

1649308545 — DR. CHANG D. CHAN O.D.
Practice Location Address:

1029 JEFFERSON BLVD , STE. G
WEST SACRAMENTO, CA
95691-3344

Practice Phone: 916-371-3421
Practice Fax: 916-371-3421

1831744010 — JONATHAN QUAN LEE DDS
Practice Location Address:

1029 JEFFERSON BLVD STE C
WEST SACRAMENTO, CA
95691-3344

Practice Phone: 916-371-2591
Practice Fax:

Directions to “JEFFERSON PHARMACY ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.