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General NPI Number Information
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NPI Number | 1750323457
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Entity Type | Organization
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Legal Business Name | JERKINS INC
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Dates
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Enumeration Date | 06/10/2006
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Last Update Date | 11/11/2024
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Provider Practice Location Address
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Address Line | 1405 GILMER AVE
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City | TALLASSEE
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State | AL
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Zip | 36078-2321
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Country | US
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Telephone | 334-283-3120
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Fax | 334-283-3126
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Provider Business Mailing Address
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Address Line | 1405 GILMER AVE
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City | TALLASSEE
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State | AL
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Zip | 36078
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Country | US
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Telephone | 334-283-3120
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Fax | 334-283-3126
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | JEFF D JERKINS
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Credential |
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Telephone | 334-749-3426
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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 | 112769
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License Number State | AL
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