NPIMap

Organization Active NPI

Jackson-Madison County General Hospital

  • Community/Retail Pharmacy
  • Jackson, TN
National Provider Identifier
1366432122
Registry record updated Jul 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
JACKSON-MADISON COUNTY GENERAL HOSPITAL
Practice address
1061 West Forest Avenue
Jackson, TN 38301-3879
Phone
(731) 660-6954
Fax
(731) 660-3549
NPI assigned
Oct 24, 2005
Organization subpart
Yes
Parent organization
JACKSON-MADISON COUNTY GENERAL HOAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 2, 2025

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

Authorized official

Name
Ms. Tina Prescott
Title
President and Ceo
Phone
(731) 541-5000

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Home Infusion Agency 251F00000X 0000003211 TN
Durable Medical Equipment & Medical Supplies 332B00000X 419 TN
Parenteral & Enteral Nutrition Supplies (DME) 332BP3500X 419 TN
Oxygen Equipment & Supplies (DME) 332BX2000X 419 TN
Pharmacy 333600000X 3211 TN
Community/Retail Pharmacy 3336C0003X Primary
Home Infusion Therapy Pharmacy 3336H0001X

Addresses

Primary practice location

1061 West Forest Avenue
Jackson, TN 38301-3879

Mailing address

1061 West Forest Avenue
Jackson, TN 38301-3879
Phone (731) 660-6954

Other identifiers 1

IdentifierTypeStateIssuer
1452390MedicaidTN

Other names 1

  • Medical Center Medical Products Infusion Services Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930019251 TN DME Supplier - PharmacyDME Supplier - Medical Supply Company With Orthotic-ProstheticDME Supplier - Medical Supply CompanyDME Supplier - Prosthetic PersonnelDME Supplier - Medical Supply Company With Registered Pharmacist 3678481975 Practice locations: Jackson, TN

Other NPIs with the same Medicare PAC ID 7

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

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.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Jackson Madison County General Hosp1061 W Forest Ave, Jackson, TN 38301-3879(731) 664-5757 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|External Infusion Pumps and/or Supplies|Breast Prostheses and/or Accessories|Enteral Nutrients|Enteral Equipment and/or Supplies|Parenteral Nutrients|Parenteral Equipment and/or Supplies Accepts assignmentParticipating since Sep 1, 2017

National Provider Directory

National Provider Directory
Tax ID family
Jere Hammond MD11 organizations share this tax ID, including this one
Part of
Jere Hammond MD

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1061 W Forest Ave
Jackson, TN 38301
Phone (731) 660-6954

Ownership & related parties

All facility ownership & control disclosures 14

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
West Tennessee Healthcare Milan HospitalMilan, TN, CCN 440060 Hospital 5% Or Greater Direct Ownership Interest (100%) Aug 27, 1998
West Tennessee Healthcare Milan HospitalMilan, TN, CCN 44U060 Hospital 5% Or Greater Direct Ownership Interest (5%) Aug 24, 1998
Jackson Madison County General HospitalJackson, TN, CCN 440002 Hospital 5% Or Greater Direct Ownership Interest (100%) Oct 31, 2007
West Tennessee Healthcare Rehabilitation Hospital Jackson, a PartnershJackson, TN, CCN 443036 Hospital 5% Or Greater Direct Ownership Interest (50%) Oct 8, 2015
West Tennessee Healthcare Rehabilitation Hospital Cane Creek, a PartneMartin, TN, CCN 443030 Hospital 5% Or Greater Direct Ownership Interest (50%) Jul 1, 2017
West Tennessee Healthcare Rehabilitation Hospital Cane Creek, a PartneMartin, TN, CCN 44Y030 Hospital 5% Or Greater Direct Ownership Interest (50%) Jul 1, 2017
West Tennessee Healthcare Volunteer HospitalMartin, TN, CCN 440061 Hospital Operational/Managerial Control Jan 2, 2019
West Tennessee Healthcare Dyersburg HospitalDyersburg, TN, CCN 440072 Hospital 5% Or Greater Direct Ownership Interest (50%)
Operational/Managerial Control (50%)		 Jun 1, 2018
Jun 1, 2018
Select Specialty Hospital - West TennesseeJackson, TN, CCN 442018 Hospital 5% Or Greater Direct Ownership Interest (15%) Mar 1, 2023
Extendicare Home Health of Western TennesseeUnion City, TN, CCN 447434 Home health agency 5% Or Greater Indirect Ownership Interest (33%) Oct 1, 2008
Extendicare Home Health of West TennesseeDyersburg, TN, CCN 447284 Home health agency 5% Or Greater Indirect Ownership Interest (33%) Sep 1, 2007
Medical Center Home Health, LLCJackson, TN, CCN 447101 Home health agency 5% Or Greater Indirect Ownership Interest (33%) Oct 1, 2008
Hospice of West TennesseeJackson, TN, CCN 441514 Hospice 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1986
West Tennessee Medical Group Primary Care CaruthersvilleCaruthersville, MO, CCN 793800 Rural health clinic Operational/Managerial Control Jun 1, 2018

Owned or controlled facilities with NPI records 13

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1130112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1751414400000",
    "number": "1366432122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1061 WEST FOREST AVENUE",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383013879",
            "telephone_number": "731-660-6954",
            "fax_number": "731-660-3549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1061 WEST FOREST AVENUE",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383013879",
            "telephone_number": "731-660-6954",
            "fax_number": "731-660-3549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON-MADISON COUNTY GENERAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "JACKSON-MADISON COUNTY GENERAL HO",
        "enumeration_date": "2005-10-24",
        "last_updated": "2025-07-02",
        "certification_date": "2025-07-02",
        "status": "A",
        "authorized_official_last_name": "PRESCOTT",
        "authorized_official_first_name": "TINA",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "731-541-5000",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251F00000X",
            "taxonomy_group": "",
            "desc": "Home Infusion",
            "state": "TN",
            "license": "0000003211",
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "TN",
            "license": "419",
            "primary": false
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": "TN",
            "license": "419",
            "primary": false
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "TN",
            "license": "419",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "TN",
            "license": "3211",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336H0001X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Home Infusion Therapy Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1452390",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medical Center Medical Products Infusion Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Medical Center Medical Products Infusion Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jackson, TN

Sources for this page

Verify at the official NPI Registry.