Jackson Drug

LBN: Jackson Drug Co
Jackson Drug is an health care organization with primary practice located at 506 2Nd St , Jackson MN 56143-0233. The organization recently has 6 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy, Suppliers / Compounding Pharmacy, Suppliers / Long Term Care Pharmacy, Suppliers / Managed Care Organization Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Jackson Drug Co can be contacted via phone (507) 847-3161, or through Edlin, Lance via phone (507) 847-3161.

Contact Information

Primary practice address
506 2Nd St Jackson MN 56143-0233
Phone: (507) 847-3161
Fax: (507) 847-2480
Website:
Map and Directions
Authorized official contact:
Name: Edlin, Lance RPH
Phone: (507) 847-3161

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Pharmacy 333600000X 22124900 Minnesota
Suppliers / Community/Retail Pharmacy 3336C0003X
Suppliers / Compounding Pharmacy 3336C0004X
Suppliers / Long Term Care Pharmacy 3336L0003X
Suppliers / Managed Care Organization Pharmacy 3336M0003X

Profile Details

NPI number 1053456889
LBN Legal business name Jackson Drug Co
DBA Doing business as Jackson Drug
Authorized official Edlin, Lance RPH
Entity Organization
Organization subpart 1 No
Enumeration date Feb 20th, 2007
Last updated Aug 13th, 2007 - about 18 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053456889 NPPES
Other 2405632 OTHER ID NUMBER-COMMERCIAL NUMBER

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