Organization
JACKSON CLINIC PHARMACY INC
Active
Other names
JACKSON CLINIC PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
DARLENE PATTON DPH (PHCY DIR)
(731) 422-0232
Entity
Organization
Contact information
Practice address
616 W FOREST AVE, JACKSON, TN 38301-3902
(731) 422-0232
(731) 422-0389
Mailing address
616 W FOREST AVE, JACKSON, TN 38301-3902
(731) 422-0232
(731) 422-0389
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
Primary
454
TN
3336C0002X
Clinic Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2095588
PK
—
Enumeration date
08/20/2006
Last updated
06/12/2013
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