Jarryd A. Jackson, PHARMD
NPI 1104190990ActiveIndividual· Pharmacist· Fayetteville, GA
Pharmacist (PHARMD) in Fayetteville, Georgia, licensed in GA, FL and TX, with an NPI issued in February 2012.
Overview
| NPI | 1104190990 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PHARMD |
| Sole proprietor | Yes |
| NPI issued | Feb 27, 2012 |
| Last updated in NPPES | Feb 27, 2012 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pharmacist Primary | 183500000X | RPH024513 | GA |
| Pharmacist | 183500000X | PS42485 | FL |
| Pharmacist | 183500000X | 46840 | TX |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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