JEROME D. JACKSON NPI 1376661934

NPI Information

  • NPI: 1376661934
  • Provider Name: JEROME D. JACKSON
  • Classification: Durable Medical Equipment & Medical Supplies - 332B00000X
  • Entity Type: Organization
  • Doing Business As: MEDICAL CENTER PHARMACY
  • Address: 1867 AIRPORT WAY
    SUITE 105
    FAIRBANKS, AK
    ZIP 99701
  • Phone: (907) 452-2328

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NPI Details

JEROME D. JACKSON is a durable medical equipment medical supplies in Fairbanks, AK. The provider is a supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time. JEROME D. JACKSON NPI is 1376661934. The provider is registered as an organization entity type.
The provider Is Doing Business As Medical Center Pharmacy.

The provider's business location address is:

1867 AIRPORT WAY
SUITE 105
FAIRBANKS, AK
ZIP 99701-007
Phone: (907) 452-2328

The provider's authorized official is Jerome D Jackson .
The authorized official title is Owner Pharmacist and has the following contact phone number (907) 452-2328.

The enumeration date for this NPI number is 3/26/2007 and was last updated on 9/6/2023.

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:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1332B00000XDurable Medical Equipment & Medical Supplies312ALASKAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
10200624OTHERALASKANABP NUMBER
2MSO268MEDICAIDALASKA
3PHO268MEDICAIDALASKA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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