NPIMap

Organization Active NPI

Jackson Hospital & Clinic, Inc.

Doing business as Jackson Apothecary, LLC

  • Community/Retail Pharmacy
  • Prattville, AL
National Provider Identifier
1376137984
Registry record updated Aug 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
JACKSON HOSPITAL & CLINIC, INC.
Doing business as
Jackson Apothecary, LLC
Practice address
1842 East Main Street
Prattville, AL 36066
Phone
(334) 293-6899
NPI assigned
Feb 24, 2021
Last updated
Aug 19, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
JACKSON HOSPITAL & CLINIC, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 19, 2026

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

Authorized official

Name
Richard F Mann
Title
Business Office Director
Phone
(334) 293-8820

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

1842 East Main Street
Prattville, AL 36066

Mailing address

1842 East Main Street
Prattville, AL 36066
Phone (334) 293-6899

Other names 1

  • Jackson Apothecary, LLC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20210324000549 AL Part B Supplier - Mass Immunization (Roster Biller Only) 0547254153 Practice locations: Pratville, AL
O20210805001900 AL Part B Supplier - Pharmacy 0547254153 Practice locations: Prattville, AL

Other NPIs with the same Medicare PAC ID 4

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

National Provider Directory

National Provider Directory
Tax ID family
Aeras71 organizations share this tax ID, including this one
Part of
Aeras

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

1725 Pine St
Ste 501
Montgomery, AL 36106

1842 E Main St
Prattville, AL 36066
Phone (334) 293-6899

NPI Registry JSON

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

{
    "created_epoch": "1614124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787097600000",
    "number": "1376137984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1842 EAST MAIN STREET",
            "city": "PRATTVILLE",
            "state": "AL",
            "postal_code": "36066",
            "telephone_number": "334-293-6899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1842 EAST MAIN STREET",
            "city": "PRATTVILLE",
            "state": "AL",
            "postal_code": "36066",
            "telephone_number": "334-293-6899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON HOSPITAL & CLINIC, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "JACKSON HOSPITAL & CLINIC, INC.",
        "enumeration_date": "2021-02-24",
        "last_updated": "2026-08-19",
        "certification_date": "2026-08-19",
        "status": "A",
        "authorized_official_last_name": "MANN",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "BUSINESS OFFICE DIRECTOR",
        "authorized_official_telephone_number": "334-293-8820"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jackson Apothecary, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Prattville, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.