| NPI | 1558028670 |
|---|---|
| Other Name | JACKSON PHARMACY |
| Entity Type | Organization |
| Authorized Contact | TRACY MCDANIEL CEO 901-842-3160 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Additional Taxonomies | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2021-11-23 |
| Last Update Date | 2024-12-06 |