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Organization
JERKINS INC
Active
Organization
JERKINS INC
Active
Other names
East Tallassee Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY D JERKINS (OWNER)
(334) 252-1688
Entity
Organization
Contact information
Practice address
4366 NOTASULGA RD, TALLASSEE, AL 36078-6035
(334) 252-1688
Mailing address
4366 NOTASULGA RD, TALLASSEE, AL 36078-6035
(334) 252-1688
(334) 252-1690
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
113373
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0136526
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
169380
—
AL
05
—
172260
—
AL
Enumeration date
06/08/2010
Last updated
02/21/2020
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