Jackson Drug Co., Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHRE004184 Issued in GA

Legal business name

JACKSON DRUG CO., INC

Practice address

10077 Commerce St
Summerville, GA 30747-1356

Phone

(706) 857-2731

Fax

(706) 857-1773

NPI assigned

Jul 14, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. James Robert Jackson, RPH

Title

Pres

Phone

(706) 857-2731

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1184640369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 120",
            "city": "SUMMERVILLE",
            "state": "GA",
            "postal_code": "307470120",
            "telephone_number": "706-857-2731",
            "fax_number": "706-857-1773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10077 COMMERCE ST",
            "city": "SUMMERVILLE",
            "state": "GA",
            "postal_code": "307471356",
            "telephone_number": "706-857-2731",
            "fax_number": "706-857-1773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON DRUG CO., INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "PRES",
        "authorized_official_telephone_number": "706-857-2731",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "GA",
            "license": "PHRE004184",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Retail Pharmacy in Summerville, GA
• Providers in Summerville, GA by specialty
• Community/Retail Pharmacy in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.