George Willie Jackson Jr., RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

RPH015360 Issued in GA

Practice address

6716 Mount Zion Boulevard
Morrow, GA 30260

Phone

(770) 960-0600

Fax

(770) 960-7146

NPI assigned

Nov 25, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Georgia CVS Pharmacy L.L.C

  • Pharmacy
  • Pooler, GA
  • NPI 1578009130
  NPD (past)
• Georgia CVS Pharmacy, L.L.C.

  • Pharmacy
  • Morrow, GA
  • NPI 1730286212
  NPD (past)

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

{
    "created_epoch": "1606262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606262400000",
    "number": "1962006445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1994 EMERALD DR",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302365218",
            "telephone_number": "770-471-2081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6716 MOUNT ZION BOULEVARD",
            "city": "MORROW",
            "state": "GA",
            "postal_code": "30260",
            "telephone_number": "770-960-0600",
            "fax_number": "770-960-7146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "GEORGE",
        "middle_name": "WILLIE",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-11-25",
        "last_updated": "2020-11-25",
        "certification_date": "2020-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "RPH015360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christy Huynh, M.D.
• Genroy Hylton Jr., APRN
• Hyltonwellness
• Integrated Healthcare Center of Morrow, LLC
• Sherrie Ivory, CPT
• Letitia N Jemison
• Jencare Neighborhood Medical Center Morrow, LLC
• Patricia Johnson-Cummings, RN
• Christian Kyle Johnson, LDO
• Crystal Johnson

• Pharmacist in Morrow, GA
• Providers in Morrow, GA by specialty
• Pharmacist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2020; 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.