Jackson, John W
Jackson, John W is an sole proprietor health care provider with primary practice located at 1667 Bellemeade Dr , Altoona PA 16602-7402. He recently has only one registered license in Pharmacy Service Providers / Pharmacist, which is considered as his primary health care specialty. Jackson, John W can be contacted via phone (814) 944-9551.Contact Information
Primary practice address
1667 Bellemeade Dr
Altoona PA 16602-7402
Phone: (814) 944-9551
Fax: (814) 944-8842
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Pharmacy Service Providers / Pharmacist | 183500000X | RP031522L | Pennsylvania |
Profile Details
| NPI number | 1275673451 |
|---|---|
| LBN Legal business name | Jackson, John W |
| Credentials | RPH |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 7th, 2007 |
| Last updated | Jul 9th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1275673451 | NPPES |
| Pennsylvania | MEDICAID | 001067292000224 |
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