JACKSON PHARMACY INC (NPI# 1811075336) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811075336 |
| Entity Type | Organization |
| Organization Name | JACKSON PHARMACY INC |
| Other Organization Name | MEDICENTER PHARMACY |
| Practice Address |
200 W Washington St Jackson MO 63755-1858 |
| Practice Telephone | 5732431303 |
| Practice Fax Number | 5732431254 |
| Mailing Telephone | 3149654700 |
| Mailing Fax Number | 5732431254 |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2014-06-30 |
| Authorized Official Name | DONALD SCHREIBER (PRESIDENT) |
| Authorized Official Telephone | 3149654700 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
Suppliers | ||
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
2009003117 | MO | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 602650608 | 05 | |
| PK | 2119180 | 01 |
| Other Name | Type Code |
|---|---|
| MediCenter Pharmacy | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184716169 | Jackson Pharmacy Inc | Pharmacy | 683 Bennetts Mills Road, Jackson, NJ 08527-3852 | 2006-09-28 |
| 1770570491 | Jackson Pharmacy Inc | Pharmacy | 1305 White Dr, Batesville, AR 72501-9467 | 2005-09-29 |
| Street Address |
200 W WASHINGTON ST |
| City | JACKSON |
| State | MO |
| Zip Code | 63755-1858 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063030476 | Heather Michelle Weber | Pharmacist | 200 W Washington St, Jackson, MO 63755-1858 | 2020-07-12 |
| 1154950764 | Christina Diane Hart | Pharmacist | 200 W Washington St, Jackson, MO 63755-1858 | 2020-04-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942847413 | Southeast Hospital | Pharmacy | 2600 E. Main Street, Suite 113, Jackson, MO 63755 | 2019-12-04 |
| 1215438585 | The Villas of Jackson LLC | Assisted Living Facility | 670 Broadridge, Jackson, MO 63755 | 2018-02-22 |
| 1346637865 | Vitality Clinic | Health Educator | 111 N. Missouri Street, Jackson, MO 63755 | 2015-04-22 |
| 1144569567 | Rock Care In Home Services, LLC | Nursing Care | 204 S Union Ave, Jackson, MO 63755 | 2013-02-05 |
| 1447506381 | Morgan Allyce Strand | Optometrist | 2954 E. Jackson Blvd, Jackson, MO 63755 | 2012-07-30 |
| 1154689321 | Benjamin Gail Goodier | Dentist | 3100 East Jackson Blvd., Jackson, MO 63755 | 2012-04-25 |
| 1912278987 | Guardian Angels Homecare, LLC | Nursing Care | 1335 Old Cape Rd., Suite F, Jackson, MO 63755 | 2012-01-23 |
| 1528357829 | Sydney Nicole Cheek | Technician, Other | 107 Cottonwood St., Jackson, MO 63755 | 2011-04-07 |
| 1215162920 | Troy L Bell Od & Associates, PC | Optometrist | 2594 E Jackson Blvd, Jackson, MO 63755 | 2009-05-26 |
| 1932398021 | Immediate Healthcare, Inc. | General Practice | 1508 Edgemont Blvd, Perryville, MO 63755 | 2007-10-15 |
| Find all providers in zip 63755 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144874868 | Whitney Harris Drugs, Inc. | Pharmacy | 1200 Eastover Dr Ste 175, Jackson, MS 39211-6317 | 2019-07-31 |
| 1013576826 | Avita Drugs Mississippi, LLC | Pharmacy | 805 E River Pl Ste A, Jackson, MS 39202-3486 | 2019-06-06 |
| 1639677230 | Walgreen Co | Pharmacy | 971 Lakeland Dr Ste 101, Jackson, MS 39216 | 2018-01-29 |
| 1952823783 | Teton County Hospital District | Pharmacy | 555 E Broadway Ave Ste 212, Jackson, WY 83001-8640 | 2017-07-13 |
| 1477955037 | Jackson Village Pharmacy LLC | Pharmacy | 27 South Cooks Bridge Rd, Suite M1, Jackson, NJ 08527 | 2014-09-25 |
| 1215341623 | Rite Aid | Pharmacy | 702 Bennett Mills Road, Jackson, NJ 08527 | 2014-06-13 |
| 1134251812 | Main Midtown Inc | Pharmacy | 346 E Fortification St, Jackson, MS 39202-2325 | 2007-03-09 |
| 1003943176 | Ljc,inc Dba Stone Drug | Pharmacy | 830 West Broadway, Box 9000, Jackson, WY 83001 | 2007-02-27 |
| 1003968322 | Carel Pharmacy | Pharmacy | 2010 W County Line Rd, Jackson, NJ 08527-2001 | 2007-01-17 |
| 1316095573 | Gold Kimball International, Inc. | Pharmacy | 2080 W County Line Rd, Jackson, NJ 08527-2015 | 2007-01-06 |
| Find all providers in JACKSON | ||||
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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.