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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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