NORTHTOWN PHARMACY LLC NPI 1023614724

NPI Details

NORTHTOWN PHARMACY LLC is a pharmacy in Jackson, MS. The provider is a facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. NORTHTOWN PHARMACY LLC NPI is 1023614724. The provider is registered as an organization entity type.

The provider's business location address is:

6220 OLD CANTON RD
JACKSON, MS
ZIP 39211-924
Phone: (601) 665-4694
Fax: (769) 333-9173

The provider's authorized official is Andrew Clark .
The authorized official title is Ceo/founder and has the following contact phone number (601) 665-4694.

The CLIA number assigned to this NPI record is 25D2210619 - pharmacy with a certificate type of Certificate of Waiver.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

• Fee covid-19 vac 14 res (HCPCS:0134A)
• Administration of influenza virus vaccine (HCPCS:G0008)
• Influenza vaccine split virus, preservative free (HCPCS:90662)
• Adm sarscov2 50mcg/0.25mlbst (HCPCS:0064A)
• Fee covid-19 vac 13 res (HCPCS:0124A)
• Adm sarscov2 30mcg/0.3ml bst (HCPCS:0004A)
• Adm sarscov2 100mcg/0.5ml3rd (HCPCS:0013A)
• Adm sarscov2 30mcg/0.3ml 3rd (HCPCS:0003A)

The enumeration date for this NPI number is 12/8/2020 and was last updated on 7/7/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available: