Organization
O.B. JACKSON INC
Active
Other names
Jackson's Furniture
Organization subpart
No
Provider details
NPI number
Authorized official
SHANNON GRANADA (MANAGER)
(256) 332-6721
Entity
Organization
Contact information
Practice address
14001 HIGHWAY 43 STE 15, RUSSELLVILLE, AL 35653-2849
(256) 332-6721
Mailing address
14001 HIGHWAY 43 STE 15, RUSSELLVILLE, AL 35653-2849
(256) 332-6721
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
03/15/2018
Last updated
03/15/2018
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