NPIMap

Organization Active NPI

Jacks Enterprises Inc

Doing business as Jack's Discount Drugs

  • Community/Retail Pharmacy
  • Midland City, AL
National Provider Identifier
1770644866
Registry record updated Oct 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
JACKS ENTERPRISES INC
Doing business as
Jack's Discount Drugs
Practice address
15073 S US Highway 231
Midtown Shopping Center
Midland City, AL 36350-6305
Phone
(334) 983-4191
Fax
(334) 983-5178
NPI assigned
Dec 12, 2006
Last updated
Oct 26, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2021

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

Authorized official

Name
Abbie Davis, PHARMD
Title
Pharmacist
Phone
(334) 983-4191

Specialties & licenses 1

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

Addresses

Primary practice location

15073 S US Highway 231
Midtown Shopping Center
Midland City, AL 36350-6305

Mailing address

15073 S US Highway 231
Midland City, AL 36350-6305
Phone (334) 983-4191

Other identifiers 2

IdentifierTypeStateIssuer
100002671MedicaidAL
1993443OtherPK

Other names 1

  • JACK'S DISCOUNT DRUGS Doing business as

National Provider Directory

National Provider Directory

Locations

15073 S US Highway 231
Midland City, AL 36350
Phone (334) 983-4191

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635206400000",
    "number": "1770644866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15073 S US HIGHWAY 231",
            "city": "MIDLAND CITY",
            "state": "AL",
            "postal_code": "363506305",
            "telephone_number": "334-983-4191",
            "fax_number": "334-983-5178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15073 S US HIGHWAY 231",
            "address_2": "MIDTOWN SHOPPING CENTER",
            "city": "MIDLAND CITY",
            "state": "AL",
            "postal_code": "363506305",
            "telephone_number": "334-983-4191",
            "fax_number": "334-983-5178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKS ENTERPRISES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-12",
        "last_updated": "2021-10-26",
        "certification_date": "2021-10-26",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "ABBIE",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "334-983-4191",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100002671",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "1993443",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "JACK'S DISCOUNT DRUGS",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "JACK'S DISCOUNT DRUGS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Midland City, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2021; 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.