Organization
JACKSONS PHARMACY LLC
Active
Organization
JACKSONS PHARMACY LLC
Active
Other names
Jacksons Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD JACKSON (PHARMACY MANAGER)
(814) 948-7400
Entity
Organization
Contact information
Practice address
2423 BETTS AVE, NORTHERN CAMBRIA, PA 15714
(814) 948-7400
(814) 948-7440
Mailing address
PO BOX 774, NORTHERN CAMBRIA, PA 15714-0774
(814) 948-7400
(814) 948-7440
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PP481874
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3991329
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
08/21/2008
Last updated
08/06/2010
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