Organization
JACKSON PHARMACY INC
Active
Other names
MediCenter Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD SCHREIBER (PRESIDENT)
(314) 965-4700
Entity
Organization
Contact information
Practice address
200 W WASHINGTON ST, JACKSON, MO 63755-1858
(573) 243-1303
(573) 243-1254
Mailing address
200 W WASHINGTON ST, JACKSON, MO 63755-1858
(314) 965-4700
(573) 243-1254
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
2009003117
MO
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2119180
PK
—
05
—
602650608
—
MO
Enumeration date
11/01/2006
Last updated
06/30/2014
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