Organization
JACKSON'S ROCKY RIDGE PHARMACY, INC
Active
Parent organization
JACKSON'S ROCKY RIDGE PHARMACY, INC
Other names
Rocky Ridge HME
Organization subpart
Yes
Provider details
NPI number
Legal business name
JACKSON'S ROCKY RIDGE PHARMACY, INC
Authorized official
DR. BRAD F JACKSON PHARM. D. (PRESIDENT)
(205) 822-5200
Entity
Organization
Contact information
Practice address
3346 MORGAN DR, BIRMINGHAM, AL 35216-3052
(205) 822-5200
(205) 979-3666
Mailing address
2108 GATEWAY DR, SUITE F, OPELIKA, AL 36801-6886
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
PENDING NPI APPROVAL
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0102018
NCPDP
AL
05
—
100003250
—
AL
01
—
515-40811
BLUE CROSS BLUE SHIELD OF ALABAMA
AL
Enumeration date
09/18/2009
Last updated
03/07/2023
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