MEDICARE: JORDAN DRUG, INC.

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	332B00000X	Durable Medical Equipment & Medical Supplies
2	332BP3500X	Parenteral & Enteral Nutrition Supplies (DME)
3	3336C0003X	Community/Retail Pharmacy	P01327	KY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	FLU0298	OTHER	KY	MEDICARE FLU

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1740216241
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JORDAN DRUG, INC.

Provider Business Mailing Address
First Line	:	PO BOX 346
Second Line	:
City	:	BEATTYVILLE
State	:	KY
Zip	:	41311-0346
Country	:	US
Telephone Number	:	606-464-3656
Fax Number	:	606-464-9002

Provider Business Practice Location Address
First Line	:	1075 HIGHWAY 11 N
Second Line	:
City	:	BEATTYVILLE
State	:	KY
Zip	:	41311-9240
Country	:	US
Telephone Number	:	606-464-3656
Fax Number	:	606-464-9002

Authorized Official
Title or Position	:	SEC/TREAS
Name	:	ROSEMARY C SMITH
Credential	:	R.PH.
Telephone Number	:	606-464-3901

Provider Enumeration Date	:	06/25/2006
Last Update Date	:	07/20/2022

Similar Medicare Providers

1790072981 — MRS. DENISE DARLENE KILBURN APRN, NP-C
Practice Location Address:

1049 HIGHWAY 11 N
BEATTYVILLE, KY
41311-9240

Practice Phone: 606-464-8806
Practice Fax:

1083950414 — JACKSON HOSPITAL CORPORATION
Practice Location Address:

1027 HIGHWAY 11 N
BEATTYVILLE, KY
41311-9240

Practice Phone: 606-464-0061
Practice Fax: 606-464-0420

1992044747 — JACKSON HOSPITAL CORPORATION
Practice Location Address:

1027 HIGHWAY 11 N
BEATTYVILLE, KY
41311-9240

Practice Phone: 606-464-0061
Practice Fax: 606-464-0420

1508327537 — MR. MICHAEL D MOORE APRN
Practice Location Address:

1031 HIGHWAY 11 N
BEATTYVILLE, KY
41311-9240

Practice Phone: 606-919-1901
Practice Fax: 606-919-1904

1346808300 — ALYSSA C ESTES APRN
Practice Location Address:

1049 HIGHWAY 11 N
BEATTYVILLE, KY
41311-9240

Practice Phone: 606-464-8806
Practice Fax: 606-464-9453

1295467124 — JUSTIN RIFFLE
Practice Location Address:

1075 HIGHWAY 11 N
BEATTYVILLE, KY
41311-9240

Practice Phone: 606-464-3656
Practice Fax:

Directions to “JORDAN DRUG, INC. ” 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.