Provider Demographics
NPI:1992327019
Name:WESTSIDE-JIFFY PHARMACY, INC
Entity type:Organization
Organization Name:WESTSIDE-JIFFY PHARMACY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST/ MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JEB
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-233-2307
Mailing Address - Street 1:1204 W MARKET ST
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:AL
Mailing Address - Zip Code:35611-4769
Mailing Address - Country:US
Mailing Address - Phone:256-233-2307
Mailing Address - Fax:256-233-2634
Practice Address - Street 1:1204 W MARKET ST
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:AL
Practice Address - Zip Code:35611-4769
Practice Address - Country:US
Practice Address - Phone:256-233-2307
Practice Address - Fax:256-233-2634
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-12
Last Update Date:2020-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies