Provider Demographics
NPI:1952889255
Name:JITNEY PHARMACIES INCORPORATED
Entity Type:Organization
Organization Name:JITNEY PHARMACIES INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:S
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-571-8861
Mailing Address - Street 1:334 DEPOT ST
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:MS
Mailing Address - Zip Code:39095-3607
Mailing Address - Country:US
Mailing Address - Phone:662-746-3253
Mailing Address - Fax:662-746-2474
Practice Address - Street 1:301 YAZOO ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:MS
Practice Address - Zip Code:39095-3644
Practice Address - Country:US
Practice Address - Phone:662-834-3378
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-30
Last Update Date:2021-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy