Organization
JACKS ENTERPRISES-DOTHAN INC
Active
Other names
JACKS DRUGS-DOTHAN
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH FLOYD (PHARMACIST IN CHARGE)
(334) 836-0890
Entity
Organization
Contact information
Practice address
1909 HONEYSUCKLE RD, DOTHAN, AL 36305-4289
(334) 836-0890
(334) 836-0894
Mailing address
1909 HONEYSUCKLE RD, DOTHAN, AL 36305-4289
(334) 836-0890
(334) 836-0894
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
112613
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0132857
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
100003604
—
AL
Enumeration date
12/13/2006
Last updated
08/28/2025
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