Organization Name: | JACKSONVILLE PHARMACY LLC |
NPI Number: | 1407022700 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JAMES KEN JOHNSON (OWNER) |
Mailing Address: | 725 N 5th St Ste 100 Jacksonville |
State: | OR US |
Postal Code: | 975309874 |
Phone Number: | 5418997948 |
Fax Number: | 5418997946 |
NPI Enumeration Date: | 05/06/2008 |
NPI Last Update Date: | 05/06/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 333600000X |
License Number: | RP002114CS |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OR |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Pharmacy |
Taxonomy Specialization: | |
Taxonomy Definition: | A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |