Provider Demographics
NPI:1407845993
Name:COMO, JACKSON A (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:JACKSON
Middle Name:A
Last Name:COMO
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1431 BADHAM DR
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35216-2910
Mailing Address - Country:US
Mailing Address - Phone:205-934-2162
Mailing Address - Fax:205-934-3501
Practice Address - Street 1:UAB HOSPITAL
Practice Address - Street 2:619 SOUTH 19TH STREET
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35249-0001
Practice Address - Country:US
Practice Address - Phone:205-934-3533
Practice Address - Fax:205-934-3501
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL9659183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist