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Organization

JERKINS INC

Active
Other names
East Tallassee Pharmacy
Organization subpart
No

Provider details

NPI number
Authorized official
JEFFREY D JERKINS (OWNER)
(334) 252-1688
Entity
Organization

Contact information

Practice address
4366 NOTASULGA RD, TALLASSEE, AL 36078-6035
(334) 252-1688
Mailing address
4366 NOTASULGA RD, TALLASSEE, AL 36078-6035
(334) 252-1688
(334) 252-1690

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
3336C0003X
Community/Retail Pharmacy
Primary
113373
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0136526
NCPDP PROVIDER IDENTIFICATION NUMBER
05
169380
AL
05
172260
AL
Enumeration date
06/08/2010
Last updated
02/21/2020
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