MR. JAMES L. JELKS JR. (NPI# 1710016233) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710016233 |
| Entity Type | Individual |
| Full Name | MR. JAMES L. JELKS JR. |
| Credential | R. PH. |
| Practice Address |
149 Main St. Centreville MS 39631-0159 |
| Mailing Address |
Po Box 159 Centreville MS 39631-0159 |
| Practice Telephone | 6016455411 |
| Practice Fax Number | 6016456454 |
| Mailing Telephone | 6016455411 |
| Mailing Fax Number | 6016456454 |
| Enumeration Date | 2007-03-02 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 183500000X | Pharmacist | E-06942 | MS | Pharmacy Service Providers |
| X | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| X | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
01649 | MS | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 00440293 | 05 | |
| MS | 00030372 | 05 |
| Street Address |
149 MAIN ST. |
| City | CENTREVILLE |
| State | MS |
| Zip Code | 39631-0159 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972159994 | Jelks Family Pharmacy, LLC | Pharmacy | 1404 Academy St, Centreville, MS 39631 | 2019-08-15 |
| 1275946162 | James Hawley | Nurse Practitioner | 260 W Main Street, Centreville, MS 39631 | 2014-06-09 |
| 1730342643 | Field Memorial Community Hospital | Internal Medicine | 270 W Main Street, Centreville, MS 39631 | 2008-07-10 |
| 1184806747 | Field Memorial Community Hospital | Nurse Practitioner | 143 West Howard St, Centreville, MS 39631 | 2007-12-05 |
| 1245528785 | Se Mississippi Emergency Physicians LLC | Emergency Medicine | 270 West Main Street, Centreville, MS 39631 | 2011-07-19 |
| 1609105014 | King Louis Chambers | Public Health or Welfare | 506 E. Main St., Suite 2a, Centreville, MS 39631 | 2009-12-14 |
| 1548244262 | Wilkinson County Nursing Center LLC | Skilled Nursing Facility | 166 S Lafayette St, Centreville, MS 39631-0310 | 2005-12-06 |
| 1992024459 | David Mcinnis Berry | Emergency Medicine | 270 W. Main St., Centreville, MS 39631-0639 | 2010-05-24 |
| 1053503318 | Wilkinson County Senior Care LLC | Skilled Nursing Facility | 166 S Lafayette St, Centreville, MS 39631-3571 | 2007-08-10 |
| 1780152561 | Charles Gerald Rymer | Pharmacist | 456 Highway 24 E, Centreville, MS 39631-4128 | 2018-11-09 |
| Find all providers in zip 39631 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780290270 | Hyojin Kim | Pharmacist | 6406 Creek Bed Ct, Centreville, VA 20121-3821 | 2020-09-20 |
| 1639736390 | Yun Hee Jang | Pharmacist | 5106 Travis Edward Way Apt I, Centreville, VA 20120-3067 | 2019-05-28 |
| 1780152561 | Charles Gerald Rymer | Pharmacist | 456 Highway 24 E, Centreville, MS 39631-4128 | 2018-11-09 |
| 1891288593 | Jaen Sidhom | Pharmacist | 13933 Middle Creek Pl, Centreville, VA 20121-3553 | 2018-06-07 |
| 1154845139 | Dien Tu | Pharmacist | 6321 Powder Flask Ct., Centreville, VA 20121 | 2017-08-01 |
| 1811253669 | Keitha V. Speer | Pharmacist | 5215 Rushbrook Dr, Centreville, VA 20120-1770 | 2012-04-05 |
| 1841591591 | Hye Joo | Pharmacist | 13405 Midnight Blue Pl, Centreville, VA 20120-3015 | 2010-11-11 |
| 1548305139 | Melody Dawn Randolph | Pharmacist | 1130 Walnut Street, Centreville, AL 35042 | 2007-02-21 |
| 1902958945 | Patricia Sterling Draper | Pharmacist | 102 S Commerce St, Centreville, MD 21617-1116 | 2007-01-18 |
| 1821699505 | John Papanastasiou | Pharmacist | 14125 Saint Germain Dr, Centreville, VA 20121-2310 | 2020-11-08 |
| Find all providers in CENTREVILLE | ||||
| City | CENTREVILLE |
| Zip Code | 39631 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.