Healthcare Provider Details

I. General information

NPI: 1699690552
Provider Name (Legal Business Name): JACKSON POLLARD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1832 ASHVILLE RD
LEEDS AL
35094-7508
US

IV. Provider business mailing address

2550 GENOA WAY
VESTAVIA AL
35243-7029
US

V. Phone/Fax

Practice location:
  • Phone: 205-702-4783
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number24813
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: