JACKSON CLINIC PHARMACY INC (NPI# 1831228618) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831228618 |
| Entity Type | Organization |
| Organization Name | JACKSON CLINIC PHARMACY INC |
| Other Organization Name | JACKSON NORTH CLINIC PHARMACY |
| Practice Address |
2863 Highway 45 Byp Jackson TN 38305-3618 |
| Practice Telephone | 7316648046 |
| Practice Fax Number | 7316608339 |
| Mailing Telephone | 7316648046 |
| Mailing Fax Number | 7316608339 |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2015-05-29 |
| Authorized Official Name | JEAN GRAY HUNDERUP (PHARMACIST IN CHARGE NOAH) |
| Authorized Official Telephone | 7316648046 |
| Authorized Official Credential | DPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3336C0002X |
Pharmacy Specialization: Clinic Pharmacy |
Suppliers | ||
| N | 3336C0004X |
Pharmacy Specialization: Compounding Pharmacy |
Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
2987 | TN | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2091766 | 01 |
| Other Name | Type Code |
|---|---|
| JACKSON NORTH CLINIC PHARMACY | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477668416 | Jackson Clinic Pharmacy Inc | Pharmacy | 616 W Forest Ave, Jackson, TN 38301-3902 | 2006-08-20 |
| Street Address |
2863 HIGHWAY 45 BYP |
| City | JACKSON |
| State | TN |
| Zip Code | 38305-3618 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285629386 | Jackson Clinic Pa | Anesthesiology | 2863 Highway 45 Byp, Jackson, TN 38305-3618 | 2005-09-14 |
| 1225644073 | Brandon Bailey | Social Worker | 2863 Highway 45 Byp, Jackson, TN 38305-3618 | 2020-09-17 |
| 1457965055 | Lauren Klyce Marbury | Nurse Practitioner | 2863 Highway 45 Byp, Jackson, TN 38305-3618 | 2020-09-02 |
| 1740813997 | Devin R Beck | Nurse Practitioner | 2863 Highway 45 Byp, Jackson, TN 38305-3618 | 2020-02-17 |
| 1477190023 | Hannah S Shaw | Nurse Practitioner | 2863 Highway 45 Byp, Jackson, TN 38305-3618 | 2019-12-03 |
| 1013550839 | Anna Kristen Whitaker Younger | Nurse Practitioner | 2863 Highway 45 Byp, Jackson, TN 38305-3618 | 2019-10-24 |
| 1770087140 | Judy L Davis | Health Educator | 2863 Highway 45 Byp, Jackson, TN 38305-3618 | 2018-03-21 |
| 1679077911 | Heather R Dieckmeyer | Health Educator | 2863 Highway 45 Byp, Jackson, TN 38305-3618 | 2018-03-21 |
| 1568961126 | Jennifer Byrd | Pharmacist | 2863 Highway 45 Byp, Jackson, TN 38305-3618 | 2018-02-08 |
| 1265962120 | Tabitha R Woodard | Nurse Practitioner | 2863 Highway 45 Byp, Jackson, TN 38305-3618 | 2017-06-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427656818 | Kimaya Jelks | Specialist | 1869 45 Hwy Bypass, Suite 2b, Jackson, TN 38305 | 2020-10-16 |
| 1821600578 | Maame Obeng | Pharmacist | 3144 North Highland Avenue, Jackson, TN 38305 | 2020-08-22 |
| 1700361904 | James Cowie | Psychologist | 156c West University Pkwy, Jackson, TN 38305 | 2018-10-03 |
| 1700372109 | Chad Zawacki | Physician Assistant | 147 North Star Drive, Jackson, TN 38305 | 2018-07-09 |
| 1104323070 | Golden Years Adult Day Care | Clinic/Center | 155 Carriage Dr Suite A, Jackson, TN 38305 | 2018-04-09 |
| 1245754563 | Tanika Annette Gillard | Massage Therapist | 4 Hampton Ln, Jackson, TN 38305 | 2017-07-28 |
| 1316488117 | Lakisha T Ingram | Counselor | 168 Greencastle Dr, Jackson, TN 38305 | 2017-03-13 |
| 1619421567 | D & L Wellness Inc | Community/Behavioral Health | 154 Carriage House Dr., Jackson, TN 38305 | 2016-08-09 |
| 1649637638 | Advance Choice Home Care LLC | In Home Supportive Care | 1028 Ashport Rd., Jackson, TN 38305 | 2016-01-21 |
| 1942666151 | Neurohealth Solutions Inc. | Clinic/Center | 174 Murray Guard Dr. Suite E, Jackson, TN 38305 | 2016-01-05 |
| Find all providers in zip 38305 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144874868 | Whitney Harris Drugs, Inc. | Pharmacy | 1200 Eastover Dr Ste 175, Jackson, MS 39211-6317 | 2019-07-31 |
| 1013576826 | Avita Drugs Mississippi, LLC | Pharmacy | 805 E River Pl Ste A, Jackson, MS 39202-3486 | 2019-06-06 |
| 1639677230 | Walgreen Co | Pharmacy | 971 Lakeland Dr Ste 101, Jackson, MS 39216 | 2018-01-29 |
| 1952823783 | Teton County Hospital District | Pharmacy | 555 E Broadway Ave Ste 212, Jackson, WY 83001-8640 | 2017-07-13 |
| 1477955037 | Jackson Village Pharmacy LLC | Pharmacy | 27 South Cooks Bridge Rd, Suite M1, Jackson, NJ 08527 | 2014-09-25 |
| 1215341623 | Rite Aid | Pharmacy | 702 Bennett Mills Road, Jackson, NJ 08527 | 2014-06-13 |
| 1134251812 | Main Midtown Inc | Pharmacy | 346 E Fortification St, Jackson, MS 39202-2325 | 2007-03-09 |
| 1003943176 | Ljc,inc Dba Stone Drug | Pharmacy | 830 West Broadway, Box 9000, Jackson, WY 83001 | 2007-02-27 |
| 1003968322 | Carel Pharmacy | Pharmacy | 2010 W County Line Rd, Jackson, NJ 08527-2001 | 2007-01-17 |
| 1316095573 | Gold Kimball International, Inc. | Pharmacy | 2080 W County Line Rd, Jackson, NJ 08527-2015 | 2007-01-06 |
| Find all providers in JACKSON | ||||
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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.