NPI 1073746988

Jack's Discount Pharmacy

Organisation Community/Retail Pharmacy Jefferson, LA

Practice location

Address: 4400 Jefferson Hwy, Jefferson, LA 70121-1309
Phone: (504) 252-4717
Fax: (504) 602-9847
Mailing address: 440 Central Ave, Jefferson, LA 70121-3408

Authorised official

Name: Lawrence Jackson
Title: LLC Member/Manager
Phone: (504) 252-4747

Registered specialties

Community/Retail Pharmacy Primary

Suppliers Taxonomy 3336C0003X

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Registry record

NPI: 1073746988
Entity type: Organization
NPI issued: 25 Aug 2009
Record last updated: 8 Sep 2010

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.