Jerkins Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

113373 Issued in AL

Legal business name

JERKINS INC

Doing business as

East Tallassee Pharmacy

Practice address

4366 Notasulga Rd
Tallassee, AL 36078-6035

Phone

(334) 252-1688

NPI assigned

Jun 8, 2010

Last updated

Feb 21, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jeffrey D Jerkins

Title

Owner

Phone

(334) 252-1688

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• East Tallassee Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in AL2 enrollments

Enrollment records 2

Other NPIs with the same Medicare PAC ID 1

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

• Jerkins Inc

  dba Bubba's Medicine Shop

  • Community/Retail Pharmacy
  • Opelika, AL
  • NPI 1851371033

  9436347044

  Same PAC ID

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Jerkins Inc

  dba Bubba's Medicine Shop

  • Community/Retail Pharmacy
  • Opelika, AL
  • NPI 1851371033

  O20110303000979

  Same enrollment

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

Tax ID family

Bubba's Medicine Shop4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

• Jerkins Inc

  dba Bubba's Medicine Shop

  • Community/Retail Pharmacy
  • Opelika, AL
  • NPI 1275867376
  NPD tax ID
• Jerkins Inc

  dba The Apothecary Shop

  • Community/Retail Pharmacy
  • Tallassee, AL
  • NPI 1750323457
  NPD tax ID
• Jerkins Inc

  dba Bubba's Medicine Shop

  • Community/Retail Pharmacy
  • Opelika, AL
  • NPI 1851371033
  NPD tax ID

Locations

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

{
    "created_epoch": "1275955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582243200000",
    "number": "1710207188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4366 NOTASULGA RD",
            "city": "TALLASSEE",
            "state": "AL",
            "postal_code": "360786035",
            "telephone_number": "334-252-1688",
            "fax_number": "334-252-1690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4366 NOTASULGA RD",
            "city": "TALLASSEE",
            "state": "AL",
            "postal_code": "360786035",
            "telephone_number": "334-252-1688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JERKINS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-08",
        "last_updated": "2020-02-21",
        "certification_date": "2020-02-21",
        "status": "A",
        "authorized_official_last_name": "JERKINS",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "334-252-1688"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "AL",
            "license": "113373",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "0136526",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "169380",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "172260",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "East Tallassee Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "East Tallassee Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ivy Creek of Elmore, LLC (Ivy Creek Family Care of Tallassee)
• Jackson Hospital & Clinic, Inc. (Jackson Clinic Urology Tallassee)
• Jackson Hospital & Clinic, Inc. (Jackson Clinic OBGYN Tallassee)
• Jackson Hospital and Clinic Inc (Jackson Clinic Cardiology)
• Linda Story Jennings, MS, RD, LD
• Jerkins Inc (The Apothecary Shop)
• John S Rose DMD PC (Tallassee Family Dentistry)
• Collin Jones
• Shawn Keahey, DDS
• Zane Penton Kelly, CRNP

• Community/Retail Pharmacy in Tallassee, AL
• Providers in Tallassee, AL by specialty
• Community/Retail Pharmacy in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2020; 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.