NPIMap

Organization Active NPI

Jackson'S Rocky Ridge Pharmacy, Inc

  • Pharmacy
  • Birmingham, AL
National Provider Identifier
1326043522
Registry record updated May 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
111519 Issued in AL
Legal business name
JACKSON'S ROCKY RIDGE PHARMACY, INC
Practice address
3346 Morgan Dr
Birmingham, AL 35216-3052
Phone
(205) 822-5200
Fax
(205) 979-3666
NPI assigned
Jun 15, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2008

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

Authorized official

Name
Dr. Brad F Jackson, PHARM D
Title
President
Phone
(205) 822-5200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 111519 AL Primary

Addresses

Primary practice location

3346 Morgan Dr
Birmingham, AL 35216-3052

Mailing address

3346 Morgan Dr
Birmingham, AL 35216-3052
Phone (205) 822-5200

Other identifiers 2

IdentifierTypeStateIssuer
100003250MedicaidAL
0102018OtherALNCPDP

Other names 1

  • rocky ridge pharmacy Doing business as

National Provider Directory

National Provider Directory

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1118793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210550400000",
    "number": "1326043522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3346 MORGAN DR",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352163052",
            "telephone_number": "205-822-5200",
            "fax_number": "205-979-3666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3346 MORGAN DR",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352163052",
            "telephone_number": "205-822-5200",
            "fax_number": "205-979-3666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON'S ROCKY RIDGE PHARMACY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-15",
        "last_updated": "2008-05-12",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "BRAD",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "205-822-5200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARM D"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "AL",
            "license": "111519",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100003250",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "0102018",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "rocky ridge pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Birmingham, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2008; 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.