Active NPI
Jackson Clinic Pharmacy Inc
- Community/Retail Pharmacy
- Jackson, TN
National Provider Identifier
1780440156
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- Legal business name
- JACKSON CLINIC PHARMACY INC
- Doing business as
- Jackson Clinic Innovation Park Pharmacy
- Practice address
- 145 Innovation Dr
Jackson, TN 38305-3019 - Phone
- (731) 422-0243
- Fax
- (731) 868-4118
- NPI assigned
- Feb 23, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Lisa Michelle King, PHARMD
- Title
- Director of Pharmacy
- Phone
- (731) 422-0247
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic Pharmacy | 3336C0002X | |||
| Community/Retail Pharmacy | 3336C0003X | Primary | ||
| Compounding Pharmacy | 3336C0004X |
Addresses
Primary practice location
145 Innovation Dr
Jackson, TN 38305-3019
Mailing address
145 Innovation Dr
Jackson, TN 38305-3019
Phone (731) 422-0247
Other names 1
- Jackson Clinic Innovation Park Pharmacy
National Provider Directory
National Provider Directory- Tax ID family
- Jackson Clinic Innovation Park Pharmacy
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Clinic Pharmacy
- Jackson, TN
- NPI 1477668416
-
- Community/Retail Pharmacy
- Jackson, TN
- NPI 1831228618
Locations
145 Innovation Dr
Jackson, TN 38305
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1708646400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1708646400000",
"number": "1780440156",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "145 INNOVATION DR",
"city": "JACKSON",
"state": "TN",
"postal_code": "383053019",
"telephone_number": "731-422-0247",
"fax_number": "731-868-4118"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "145 INNOVATION DR",
"city": "JACKSON",
"state": "TN",
"postal_code": "383053019",
"telephone_number": "731-422-0243",
"fax_number": "731-868-4118"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "JACKSON CLINIC PHARMACY INC",
"organizational_subpart": "NO",
"enumeration_date": "2024-02-23",
"last_updated": "2024-02-23",
"certification_date": "2024-02-23",
"status": "A",
"authorized_official_last_name": "KING",
"authorized_official_first_name": "LISA",
"authorized_official_middle_name": "MICHELLE",
"authorized_official_title_or_position": "DIRECTOR OF PHARMACY",
"authorized_official_telephone_number": "731-422-0247",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "PHARMD"
},
"taxonomies": [
{
"code": "3336C0002X",
"taxonomy_group": "",
"desc": "Pharmacy, Clinic Pharmacy",
"state": null,
"license": null,
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": null,
"license": null,
"primary": true
},
{
"code": "3336C0004X",
"taxonomy_group": "",
"desc": "Pharmacy, Compounding Pharmacy",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Jackson Clinic Innovation Park Pharmacy",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Jackson, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.