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General NPI Number Information
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NPI Number | 1851371033
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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 | 01/22/2006
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Last Update Date | 02/19/2020
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Provider Practice Location Address
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Address Line | 512 2ND AVE
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City | OPELIKA
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State | AL
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Zip | 36801-4316
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Country | US
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Telephone | 334-749-3426
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Fax | 334-742-0757
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Provider Business Mailing Address
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Address Line | 512 2ND AVE
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City | OPELIKA
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State | AL
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Zip | 36801-4316
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Country | US
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Telephone | 334-749-3426
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Fax | 334-742-0757
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Authorized Official
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Title or Position | PHARMACIST/NEW OWNER
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Name | JEFF 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 | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 101890
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License Number State | AL
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