Organization
JACKSON'S DISCOUNT PHARMACY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LINDA MARIE JACKSON (VICE PRESIDENT)
(228) 832-8000
Entity
Organization
Contact information
Practice address
11340 THREE RIVERS RD STE A, GULFPORT, MS 39503-3650
(228) 832-0808
Mailing address
11340 THREE RIVERS RD STE A, GULFPORT, MS 39503-3650
(228) 832-0808
Taxonomy
Speciality
Code
Description
License number
State
3336S0011X
Specialty Pharmacy
Primary
02264011
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00440464
—
MS
Enumeration date
06/27/2007
Last updated
04/11/2008
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