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Organization
NORTH JEFFERSON PHARMACY, INC.
Active
Organization
NORTH JEFFERSON PHARMACY, INC.
Active
Other names
North Jefferson Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN ROBERT WILSON R.PH. (PRESIDENT)
(205) 502-1010
Entity
Organization
Contact information
Practice address
341 WALKER CHAPEL PLAZA, SUITE 109, FULTONDALE, AL 35068-0903
(205) 502-1010
(205) 502-1012
Mailing address
PO BOX 903, FULTONDALE, AL 35068-0903
(205) 502-1010
(205) 502-1012
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
110415
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0115281
NCPDP NUMBER
—
05
—
100002687
—
AL
Enumeration date
02/28/2007
Last updated
08/06/2009
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