Organization
DEL MAR MEDICAL, INC.
Active
Organization
DEL MAR MEDICAL, INC.
Active
Other names
Del Mar Medical
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICKEY JACKSON (OWNER/PRESIDENT)
(615) 754-4667
Entity
Organization
Contact information
Practice address
198 E DIVISION ST, MT JULIET, TN 37122-3324
(615) 754-4667
(615) 754-2582
Mailing address
PO BOX 787, MOUNT JULIET, TN 37121-0787
(615) 754-4667
(615) 758-5878
Taxonomy
Speciality
Code
Description
License number
State
3336I0012X
Institutional Pharmacy
2078
TN
3336L0003X
Long Term Care Pharmacy
Primary
2078
TN
3336M0002X
Mail Order Pharmacy
2078
TN
Other
Enumeration date
08/13/2006
Last updated
03/09/2017
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