NPIMap

Organization Active NPI

Jacks Enterprises-Dothan Inc

  • Community/Retail Pharmacy
  • Dothan, AL
National Provider Identifier
1215098033
Registry record updated May 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
112613 Issued in AL
Legal business name
JACKS ENTERPRISES-DOTHAN INC
Practice address
1909 Honeysuckle Rd
Dothan, AL 36305-4289
Phone
(334) 836-0890
Fax
(334) 836-0894
NPI assigned
Dec 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 18, 2026

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

Authorized official

Name
Matthew Dixon
Title
Business Manager
Phone
(334) 836-0890

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 112613 AL Primary

Addresses

Primary practice location

1909 Honeysuckle Rd
Dothan, AL 36305-4289

Mailing address

1909 Honeysuckle Rd
Dothan, AL 36305-4289
Phone (334) 836-0890

Other identifiers 2

IdentifierTypeStateIssuer
100003604MedicaidAL
0132857OtherNCPDP PROVIDER IDENTIFICATION NUMBER

Other names 1

  • JACKS DRUGS-DOTHAN Doing business as

National Provider Directory

National Provider Directory

Locations

1909 Honeysuckle Rd
Dothan, AL 36305
Phone (334) 836-0890

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1779062400000",
    "number": "1215098033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1909 HONEYSUCKLE RD",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363054289",
            "telephone_number": "334-836-0890",
            "fax_number": "334-836-0894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1909 HONEYSUCKLE RD",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363054289",
            "telephone_number": "334-836-0890",
            "fax_number": "334-836-0894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKS ENTERPRISES-DOTHAN INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-13",
        "last_updated": "2026-05-18",
        "certification_date": "2026-05-18",
        "status": "A",
        "authorized_official_last_name": "DIXON",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "334-836-0890"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "AL",
            "license": "112613",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100003604",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "0132857",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "JACKS DRUGS-DOTHAN",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dothan, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2026; 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.