Provider Demographics
NPI:1821164401
Name:J & M PHARMACY INC
Entity Type:Organization
Organization Name:J & M PHARMACY INC
Other - Org Name:JONES DRUGS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/MGR
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:E
Authorized Official - Last Name:HOLT
Authorized Official - Suffix:JR
Authorized Official - Credentials:R PHARMACIST
Authorized Official - Phone:256-423-2155
Mailing Address - Street 1:PO BOX 429
Mailing Address - Street 2:
Mailing Address - City:ARDMORE
Mailing Address - State:TN
Mailing Address - Zip Code:38449-0429
Mailing Address - Country:US
Mailing Address - Phone:256-423-2155
Mailing Address - Fax:256-423-8999
Practice Address - Street 1:30508 ARDMORE AVENUE
Practice Address - Street 2:
Practice Address - City:ARDMORE
Practice Address - State:AL
Practice Address - Zip Code:35739-7443
Practice Address - Country:US
Practice Address - Phone:256-423-2155
Practice Address - Fax:256-423-8999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-27
Last Update Date:2015-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009905545Medicaid
AL51052971OtherDME
TN3114962OtherMEDICARE SUPPLEMENT
TN4582027Medicaid
TN3114962OtherMEDICARE SUPPLEMENT