Jackson Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

28RS00342600 Issued in NJ

Legal business name

JACKSON PHARMACY INC

Practice address

683 Bennetts Mills Road
Jackson, NJ 08527-3852

Phone

(732) 833-0400

Fax

(732) 833-1006

NPI assigned

Sep 28, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Paul A Howe Sr., RPH

Title

RPH in Charge/Owner

Phone

(732) 833-0400

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1184716169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "683 BENNETTS MILLS ROAD",
            "city": "JACKSON",
            "state": "NJ",
            "postal_code": "085273852",
            "telephone_number": "732-833-0400",
            "fax_number": "732-833-1006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "683 BENNETTS MILLS ROAD",
            "city": "JACKSON",
            "state": "NJ",
            "postal_code": "085273852",
            "telephone_number": "732-833-0400",
            "fax_number": "732-833-1006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HOWE",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "RPH IN CHARGE/OWNER",
        "authorized_official_telephone_number": "732-833-0400",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NJ",
            "license": "28RS00342600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4349300",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP",
            "identifier": "3110121",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jackson Center for Foot and Ankle Medicine,LLC
• Jackson Family Foot & Ankle Care, LLC
• Jackson Joint Ventures Limited Liability
• Jackson Orthodontics LLC
• Jackson Pediatric Dentistry PC
• Jackson Surgical Center LLC
• Jackson Township First Aid Squad Inc
• Jackson Village Imaging, LLC
• Jackson Village Pharmacy LLC
• Jackson Village Pharmacy LLC

• Community/Retail Pharmacy in Jackson, NJ
• Providers in Jackson, NJ by specialty
• Community/Retail Pharmacy in New Jersey

• 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.