Organization
JACKSONVILLE PHARMACY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. J. KEN JOHNSON R.PH. (PRESIDENT)
(541) 899-7948
Entity
Organization
Contact information
Practice address
725 N 5TH ST, STE 100, JACKSONVILLE, OR 97530-9874
(541) 899-7948
(541) 899-7946
Mailing address
725 N 5TH ST, STE 100, JACKSONVILLE, OR 97530-9874
(541) 899-7948
(541) 899-7946
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
275501
—
OR
Enumeration date
04/07/2006
Last updated
05/06/2008
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