NPI 1639694763

The Jackson Group, LLC

Organisation Medical Foods Supplier Baton Rouge, LA

Practice location

Address: 3608 President Davis Dr, Baton Rouge, LA 70816-2947
Phone: (225) 421-6772
Fax: (225) 308-8909

Authorised official

Name: Rolanda Gayle Young
Title: Owner
Phone: (225) 421-6772

Registered specialties

Medical Foods Supplier Primary

Suppliers Taxonomy 335G00000X

Other Medical Foods Supplier providers in Louisiana →

Registry record

NPI: 1639694763
Entity type: Organization
NPI issued: 10 Aug 2017
Record last updated: 10 Aug 2017

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.