Provider Demographics
NPI:1558708651
Name:JMB PHARMACY, LLC
Entity Type:Organization
Organization Name:JMB PHARMACY, LLC
Other - Org Name:BROOKE'S PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BROOKE
Authorized Official - Middle Name:H
Authorized Official - Last Name:ALBRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:770-834-9050
Mailing Address - Street 1:PO BOX 201
Mailing Address - Street 2:
Mailing Address - City:ROOPVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30170-0201
Mailing Address - Country:US
Mailing Address - Phone:770-834-9050
Mailing Address - Fax:
Practice Address - Street 1:812 S PARK ST
Practice Address - Street 2:SUITE 5A
Practice Address - City:CARROLLTON
Practice Address - State:GA
Practice Address - Zip Code:30117-4412
Practice Address - Country:US
Practice Address - Phone:770-834-9050
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-29
Last Update Date:2013-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy