Individual
JEREMY A JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
257 S HWY 18 BYPASS, MANILA, AR 72442
(870) 561-3113
(870) 561-4291
Mailing address
PO BOX 372, MANILA, AR 72442-0372
(870) 561-3113
(870) 561-4291
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PD08748
AR
Other
Enumeration date
12/04/2020
Last updated
12/04/2020
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