Jackson Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

AR13396 Issued in AR

Legal business name

JACKSON PHARMACY INC

Doing business as

OAK PARK PHARMACY

Practice address

1305 White Dr
Batesville, AR 72501-9467

Phone

(870) 698-1974

Fax

(870) 698-0141

NPI assigned

Sep 29, 2005

Organization subpart

No

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

Authorized official

Name

Lonnie Jackson, PDNPI 1477637841

Title

President

Phone

(870) 698-1974

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• OAK PARK PHARMACY Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lonnie Everrett Jackson III, P.D.

  • Pharmacist
  • Batesville, AR
  • NPI 1477637841
  NPD (past) Authorized official

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

{
    "created_epoch": "1127952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480896000000",
    "number": "1770570491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2114",
            "city": "BATESVILLE",
            "state": "AR",
            "postal_code": "725032114",
            "telephone_number": "870-698-1974",
            "fax_number": "870-698-0141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 WHITE DR",
            "city": "BATESVILLE",
            "state": "AR",
            "postal_code": "725019467",
            "telephone_number": "870-698-1974",
            "fax_number": "870-698-0141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-29",
        "last_updated": "2016-12-05",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "LONNIE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "870-698-1974",
        "authorized_official_credential": "PD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "AR",
            "license": "AR13396",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "1994353",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "114918407",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OAK PARK PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Invigorate Weight Loss & Wellness
• Stacy Jo Isbell, LCSW
• Andrea Isley
• Meagan Ivy
• Izard Regional Hospital, LLC
• Benjamin Taylor Jackson, MD
• Cynthia Elaine Jackson, APN
• Lonnie Everrett Jackson III, P.D.
• McKenzie Jackson
• Patricia Ann Jackson, DC

• Community/Retail Pharmacy in Batesville, AR
• Providers in Batesville, AR by specialty
• Community/Retail Pharmacy in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2016; 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.