# JERKINS INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** East Tallassee Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1710207188
- **Authorized official:** JEFFREY D JERKINS (OWNER)
- **Authorized official phone:** (334) 252-1688

## Contact information

- **Practice address:** 4366 NOTASULGA RD, TALLASSEE, AL 36078-6035
- **Practice address phone:** (334) 252-1688
- **Mailing address:** 4366 NOTASULGA RD, TALLASSEE, AL 36078-6035
- **Mailing address phone:** (334) 252-1688
- **Mailing address fax:** (334) 252-1690

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 113373 | AL | Yes |

## Other

- **Enumeration date:** 06/08/2010
- **Last updated:** 02/21/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0136526 | NCPDP PROVIDER IDENTIFICATION NUMBER | — |
| 05 | — | 169380 | — | AL |
| 05 | — | 172260 | — | AL |