Provider Demographics
NPI:1194350256
Name:JR SCRIPTS PHARMACY NO 1 LLC
Entity type:Organization
Organization Name:JR SCRIPTS PHARMACY NO 1 LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:J
Authorized Official - Last Name:VENCEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-234-8305
Mailing Address - Street 1:1238 S 3RD ST STE C
Mailing Address - Street 2:
Mailing Address - City:TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47802-1006
Mailing Address - Country:US
Mailing Address - Phone:812-234-8305
Mailing Address - Fax:812-234-0225
Practice Address - Street 1:2902 POPLAR ST
Practice Address - Street 2:
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47803-2661
Practice Address - Country:US
Practice Address - Phone:812-478-1006
Practice Address - Fax:812-478-9296
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-10
Last Update Date:2020-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy