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General NPI Number Information
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NPI Number | 1124427851
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Entity Type | Organization
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Legal Business Name | JOHNSON RX INC
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Dates
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Enumeration Date | 08/19/2014
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Last Update Date | 03/24/2017
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Provider Practice Location Address
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Address Line | 1642 PELHAM RD S
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City | JACKSONVILLE
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State | AL
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Zip | 36265-3312
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Country | US
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Telephone | 256-706-6845
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Fax | 888-537-4507
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Provider Business Mailing Address
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Address Line | 4055 ALABAMA HWY 9 SUITE F
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City | CEDAR BLUFF
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State | AL
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Zip | 35959
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Country | US
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Telephone | 256-779-3000
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Fax |
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Authorized Official
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Title or Position | OWNER/PHARMACIST
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Name | COPELAND JOHNSON
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Credential | PHARMACIST
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Telephone | 256-504-2253
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 114403
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License Number State | AL
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