Organization
JACKSONS DRUGS OF MONTICELLO, INC.
Active
Other names
Jackson's Drug Store
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES D JACKSON R.PH. (VP)
(850) 948-3011
Entity
Organization
Contact information
Practice address
1308 SW GRAND ST, GREENVILLE, FL 32331
(850) 948-3011
(850) 948-3778
Mailing address
PO BOX 129, GREENVILLE, FL 32331-0129
(850) 948-3011
(850) 948-3778
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PH12505
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102475200
—
FL
Enumeration date
02/07/2007
Last updated
03/25/2009
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