# JACK'S DISCOUNT PHARMACY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073746988
- **Authorized official:** MR. LAWRENCE JACKSON JR. RPH (LLC MEMBER/MANAGER)
- **Authorized official phone:** (504) 252-4747

## Contact information

- **Practice address:** 4400 JEFFERSON HWY, JEFFERSON, LA 70121-1309
- **Practice address phone:** (504) 252-4717
- **Practice address fax:** (504) 602-9847
- **Mailing address:** 440 CENTRAL AVE, JEFFERSON, LA 70121-3408
- **Mailing address phone:** (504) 252-4717
- **Mailing address fax:** (504) 602-9847

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 08/25/2009
- **Last updated:** 09/08/2010