MEDICARE: JERRY'S PHARMACY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	07008524	AL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	105634	OTHER	AL	STATE LICENSE
2	0114568	OTHER	AL	NABP
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1194802892
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JERRY'S PHARMACY

Provider Business Mailing Address
First Line	:	1532 HUFFMAN RD
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35215-5621
Country	:	US
Telephone Number	:	205-853-1293
Fax Number	:

Provider Business Practice Location Address
First Line	:	1532 HUFFMAN RD
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35215-5621
Country	:	US
Telephone Number	:	205-853-1293
Fax Number	:

Authorized Official
Title or Position	:	OWNER/PHARMACIST
Name	:	CHARLES JERRY GARRISON
Credential	:	RPH.
Telephone Number	:	205-853-1293

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	03/07/2023

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Directions to “JERRY'S PHARMACY ” Practice Location

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