Jackson Oncology Associates
Organization Active NPI Community/Retail Pharmacy · Jackson, MS
NPI 1780192690 · NPPES record last updated Nov 9, 2021
Key facts
- NPI
- 1780192690
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- Legal business name
- JACKSON ONCOLOGY ASSOCIATES
- Practice address
- 1227 N State St Ste 101
Jackson, MS 39202-2002 - Phone
- (601) 355-2485
- Fax
- (601) 353-1463
- NPI assigned
- Jan 12, 2018
- Organization subpart
- Yes
- Parent organization (as reported)
- JACKSON ONCOLOGY ASSOCIATES
Authorized official
- Name
- Richard W Griffith
- Title
- Executive Director
- Phone
- (601) 974-5578
Parent organization (reported in NPPES) 1
Other NPIs with the same Medicare PAC ID 1
Corporate family (same tax ID) 6
Practitioners 16
-
Justin T Baker, M.D.
-
Ramona M Ball, FNP
-
Lori Beth Brent, FNP
-
Elizabeth Herrington, D.O.
-
Meaghan Schenk Johnson, FNP-C
-
Manubhai S Patel, M.D.
-
Guangzhi Qu, M.D.
-
Tammy H Young, M.D.
-
Sarah Ballinger, NPC
-
Sarah Danielle Cockrell, FNP-C
-
Laura Lynn Keys, N.P.-C
Laboratory certificates & supplier records
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Jackson Oncology Associates PLLC |
Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs | Accepts assignment |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20180221002550 | MS | Part B Supplier - Pharmacy | 2860392735 | Practice locations: Jackson, MS |
National Provider Directory
- Tax ID family
- Jackson Oncology Associates
- Part of
- Jackson Oncology Associates
Locations
1860 Chadwick Dr
Ste 301
Jackson, MS 39204
Phone (601) 373-4421
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | MS | Yes |
Addresses
Primary practice location
1227 N State St Ste 101
Jackson, MS 39202-2002
Mailing address
1227 N State St Ste 101
Jackson, MS 39202-2002
Phone (601) 355-2485
Other names
- JACKSON ONCOLOGY ASSOCIATES, PLLC ORAL DISPENSE PHARMACY
Other providers in Jackson, MS
- Jackson Ms Homecare
- Jackson Neurocare, PLLC
- Jackson Neurology Associates
- Jackson Neurosurgery Clinic PLLC
- Jackson Oncology Associates
- Jackson Oncology Associates, PLLC
- Jackson Oncology Associates,PLLC
- Jackson Orthopaedic Clinic, PA
- Jackson Pain Center PA
- Jackson Pediatric Associates P a
All providers in Jackson, MS · Community/Retail Pharmacy in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 9, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.