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General NPI Number Information
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NPI Number | 1194802892
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Entity Type | Organization
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Legal Business Name | JERRY'S PHARMACY
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 1532 HUFFMAN RD
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City | BIRMINGHAM
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State | AL
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Zip | 35215-5621
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Country | US
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Telephone | 205-853-1293
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Fax |
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Provider Business Mailing Address
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Address Line | 1532 HUFFMAN RD
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City | BIRMINGHAM
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State | AL
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Zip | 35215-5621
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Country | US
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Telephone | 205-853-1293
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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 | CHARLES JERRY GARRISON
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Credential | RPH.
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Telephone | 205-853-1293
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 07008524
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License Number State | AL
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