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Individual

CHARLES WAYNE JACKSON JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHARMACIST

Contact information

Practice address
2451 N 90TH ST, OMAHA, NE 68134-6009
(402) 609-5275
Mailing address
2451 N 90TH ST, OMAHA, NE 68134-6009
(402) 609-5275

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
16860
NE

Other

Enumeration date
08/07/2020
Last updated
08/07/2020
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