MR. JACK LARRY SANDERS (NPI# 1619050150) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619050150 |
| Entity Type | Individual |
| Full Name | MR. JACK LARRY SANDERS |
| Credential | R PH |
| Practice Address |
3160 Audubon Dr Laurel MS 39440 |
| Mailing Address |
Po Box 8324 Laurel MS 39441-8324 |
| Practice Telephone | 6014280688 |
| Practice Fax Number | 6014280689 |
| Mailing Telephone | 6017294407 |
| Mailing Fax Number | 6014280689 |
| Enumeration Date | 2006-10-20 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | E-06744 | MS | Pharmacy Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | STATE LICENSE NUMBER | E-06744 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588738652 | Jack Charles Sanders | Social Worker | 6650 North Northwest Hwy, Suite 201, Chicago, IL 60631-1307 | 2006-11-20 |
| Street Address |
3160 AUDUBON DR |
| City | LAUREL |
| State | MS |
| Zip Code | 39440 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780625897 | James L. Hicks, IIi | Pharmacist | 3160 Audubon Dr, Laurel, MS 39440-1926 | 2006-06-09 |
| 1649209305 | Northlaurel Discount Drugs, Inc. | Pharmacy | 3160 Audubon Dr, Laurel, MS 39440-1926 | 2006-07-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306323159 | Tender Loving Care Homecare LLC | Homemaker | 509 Central Ave Ste 224, Laurel, MS 39440 | 2018-07-24 |
| 1669837910 | Laurel Dental Properties | Dentist | 1925 Pine Belt Drive, Laurel, MS 39440 | 2015-12-30 |
| 1215282991 | South Central Regional Medical Center | Clinic/Center | 525 Wayne Drive, Laurel, MS 39440 | 2012-07-18 |
| 1568721215 | Terry Ratcliff Perkins | Counselor | 5192 Hwy 11 North, Laurel, MS 39440 | 2012-05-15 |
| 1437453057 | Alexander Milne Home for Women | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 616 East 19th Street, Laurel, MS 39440 | 2010-12-23 |
| 1710135629 | Jeffrey R. Moffett | Nurse Practitioner | 3115 Audubon Dr, Laurel, MS 39440 | 2008-09-04 |
| 1003096785 | Family Health Center, Inc | Obstetrics & Gynecology | 103 S. 12th Avenue, Laurel, MS 39440 | 2007-11-09 |
| 1669672143 | Laurel Urology Clinic Pa | Urology | 304 S 10th Ave, Laurel, MS 39440 | 2007-07-23 |
| 1093912370 | Tanweer Hussain Majid | Surgery | 1007 Jefferson Street, Laurel, MS 39440 | 2007-06-29 |
| 1780889923 | Hattiesburg Eye Clinic, Pa | Ophthalmology | 1431 North 10th St, Suite 1, Laurel, MS 39440 | 2007-06-18 |
| Find all providers in zip 39440 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295336618 | Rupesh Sheth | Pharmacist | Sams's Club, 3535 Russett Green E, Laurel, MD 20724 | 2020-11-03 |
| 1518574813 | Sharareh Khanjani | Pharmacist | 3535 Russett Grn E, Laurel, MD 20724-1810 | 2020-09-30 |
| 1891307161 | Rudolf Achiri | Pharmacist | 515 Main St Ste 211, Laurel, MD 20707-4117 | 2020-08-18 |
| 1205444908 | Nazia R Khan | Pharmacist | 3611 Chase Hills Dr, Laurel, MD 20724-1925 | 2020-07-19 |
| 1013525252 | Adesoji Babatunde Adelakun | Pharmacist | 922 5th St, Laurel, MD 20707-5106 | 2020-07-14 |
| 1952928442 | Solomon Tesfatsion | Pharmacist | 7350 Van Dusen Rd # 101, Laurel, MD 20707-5263 | 2020-06-30 |
| 1740777697 | Jeen Min | Pharmacist | 9423 Fens Holw, Laurel, MD 20723-5731 | 2018-04-17 |
| 1265958367 | Lanre Abayomi | Pharmacist | 12906 N Point Ln, Laurel, MD 20708-2344 | 2017-08-21 |
| 1477009744 | Anya Kalu Uzoh | Pharmacist | 3048 Shoreline Blvd, Laurel, MD 20724-1970 | 2016-08-28 |
| 1659754570 | Amber Guinn | Pharmacist | 725 Sawmill Rd, Laurel, MS 39440-3971 | 2015-07-09 |
| Find all providers in LAUREL | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.