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Organization

JACKSON CLINIC PA

Active
Parent organization
JACKSON CLINIC PA
Other names
JACKSON CLINC PA DME
Organization subpart
Yes

Provider details

NPI number
Legal business name
JACKSON CLINIC PA
Authorized official
MARK ALLEN (C.E.O.)
(731) 422-0330
Entity
Organization

Contact information

Practice address
145 INNOVATION DR, JACKSON, TN 38305-3019
(731) 422-0213
Mailing address
PO BOX 400, JACKSON, TN 38302-0400
(731) 423-8697
(731) 425-5783

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary

Other

Enumeration date
12/27/2023
Last updated
12/27/2023
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