Organization
JEFFREY SCOTT JACKSON
Active
Other names
TOXAWAY PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY JACKSON RPH (OWNER)
(828) 884-3784
Entity
Organization
Contact information
Practice address
16821 ROSMAN HWY, LAKE TOXAWAY, NC 28747-9593
(828) 884-3784
(828) 884-3792
Mailing address
16821 ROSMAN HWY, LAKE TOXAWAY, NC 28747-9593
(828) 884-3784
(828) 884-3792
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
06268
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0885202A
—
NC
01
—
3432933
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
12/26/2006
Last updated
01/20/2012
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