Organization Active NPI

JPWC LLC

Doing business as Jackson Pharmacy & Wellness Center

  • Community/Retail Pharmacy
  • Jackson Center, OH
National Provider Identifier
1215351077
Registry record updated Sep 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
022374400 Issued in OH
Legal business name
JPWC LLC
Doing business as
Jackson Pharmacy & Wellness Center
Practice address
101B E Pike St
Jackson Center, OH 45334-6000
Phone
(937) 596-8100
Fax
(937) 596-8108
NPI assigned
Feb 13, 2014
Last updated
Sep 30, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2019

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

Authorized official

Name
Allison Haas, PHARMD
Title
President
Phone
(937) 596-8100

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X NU
Community/Retail Pharmacy 3336C0003X 022374400 OH Primary
Compounding Pharmacy 3336C0004X NU

Addresses

Primary practice location

101B E Pike St
Jackson Center, OH 45334-6000

Mailing address

PO Box 882
Jackson Center, OH 45334-0882
Phone (937) 596-8100

Other identifiers 2

IdentifierTypeStateIssuer
2144291OtherPK
0098109MedicaidOH

Other names 1

  • Jackson Pharmacy & Wellness Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141118001435 OH Part B Supplier - Mass Immunization (Roster Biller Only) 6507097318 Practice locations: Jackson Center, OH

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D2121415Jackson Pharmacy & Wellness Center101B E Pike Street, Jackson Center, OH 45334Certificate of waiverNov 3, 2026

National Provider Directory

National Provider Directory

Locations

101 E Pike St
#B
Jackson Center, OH 45334
Phone (937) 596-3100

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1392249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1569801600000",
    "number": "1215351077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 882",
            "city": "JACKSON CENTER",
            "state": "OH",
            "postal_code": "453340882",
            "telephone_number": "937-596-8100",
            "fax_number": "937-596-8108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101B E PIKE ST",
            "city": "JACKSON CENTER",
            "state": "OH",
            "postal_code": "453346000",
            "telephone_number": "937-596-8100",
            "fax_number": "937-596-8108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JPWC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-13",
        "last_updated": "2019-09-30",
        "status": "A",
        "authorized_official_last_name": "HAAS",
        "authorized_official_first_name": "ALLISON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "937-596-8100",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OH",
            "license": "022374400",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2144291",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0098109",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jackson Pharmacy & Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Jackson Pharmacy & Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jackson Center, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.