Organization
JACKSON CLINIC PHARMACY INC
Active
Other names
JACKSON NORTH CLINIC PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JEAN GRAY HUNDERUP DPH (PHARMACIST IN CHARGE NOAH)
(731) 664-8046
Entity
Organization
Contact information
Practice address
2863 HIGHWAY 45 BYP, JACKSON, TN 38305-3618
(731) 664-8046
(731) 660-8339
Mailing address
2863 HIGHWAY 45 BYP, JACKSON, TN 38305-3618
(731) 664-8046
(731) 660-8339
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
2987
TN
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2091766
PK
—
Enumeration date
03/05/2007
Last updated
05/29/2015
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