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NORTHTOWN PHARMACY LLC
NPI 1023614724
Pharmacy in Jackson, MS

Active since December 08, 2020CLIA 25D2210619 · Waiver
6220 OLD CANTON RD, JACKSON, MS 39211(601) 665-4694(769) 333-9173 Get Directions Write a Review

NPPES record last updated: July 7, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 7, 2021, Mar 31, 2021, Dec 8, 2020 (3 updates tracked since 2020).

About Northtown Pharmacy Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NORTHTOWN PHARMACY LLC (NPI 1023614724) is a healthcare organization registered as a pharmacy in Jackson, Mississippi and active in the NPI registry since December 2020. The organization holds a CLIA Waiver certificate valid through January 21, 2027 and lists Andrew Clark, Ceo/founder, as its authorized official.

NPPES Registry Identity

NPI1023614724
Entity TypeOrganization
Primary Taxonomy333600000X
Legal Business NameNORTHTOWN PHARMACY LLC
Location Address6220 OLD CANTON RDJackson, MS 39211-2924
Mailing Address6220 Old Canton RdJackson, MS 39211-2924 · (601) 665-4694 · Fax (769) 333-9173
Phone(601) 665-4694
Fax(769) 333-9173
Organization SubpartNo
Authorized OfficialAndrew ClarkCeo/founder · (601) 665-4694
Enumeration DateDecember 8, 2020
Last NPPES UpdateJuly 7, 20213 updates tracked since enumeration
NPPES CertifiedJuly 7, 2021
✔ NPI 1023614724 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPharmacySuppliers
Taxonomy Code333600000X
Definition
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.
Also ListedPharmacy · Community/Retail PharmacyTaxonomy 3336C0003X
6220 OLD CANTON RD, Jackson, MS 39211
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter from Arizona Complete Health and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 25D2210619

Northtown Pharmacy · Jackson, MS
Active · expires Jan 21, 2027
CLIA Number25D2210619
Laboratory TypePharmacy
Certificate Effective DateJanuary 22, 2025
Certificate Expiration DateJanuary 21, 2027
Laboratory DirectorAndrew Clark
Laboratory Phone(601) 503-0558
Laboratory LocationNorthtown Pharmacy6220 Old Canton Road, Jackson, MS 39211
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
106 services100 patients
Influenza vaccine, inactivated 90653
The Influenza vaccine, inactivated, is a shot given to protect against the flu. It contains killed virus particles that help your body build immunity to the flu. It's recommended annually to keep your protection up-to-date. It's safe for ages 6 months and up.
81 services78 patients

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ZACHARY MCINNIS
Pharmacist
6220 OLD CANTON RD
JACKSON, MS 39211
Hinds County (601) 665-4694
NORTHTOWN PHARMACY LLC
Pharmacy (Community/Retail Pharmacy)
6220 OLD CANTON RD
JACKSON, MS 39211
Hinds County (601) 665-4694
DR. ANDREW CLARK PHARM D
Pharmacist
6220 OLD CANTON RD
JACKSON, MS 39211
Hinds County (601) 503-0558

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Northtown Pharmacy LLC's NPI number?

The NPI number for Northtown Pharmacy LLC is 1023614724. It was assigned to this organization in the NPPES registry on December 8, 2020.

Where is Northtown Pharmacy LLC located?

Northtown Pharmacy LLC is located at 6220 Old Canton Rd, Jackson, MS 39211. The listed phone number is (601) 665-4694.

What is Northtown Pharmacy LLC's specialty?

The primary specialty registered for this NPI is Pharmacy with taxonomy code 333600000X.

Does Northtown Pharmacy LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 25D2210619) is associated with this NPI, valid through January 21, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Northtown Pharmacy LLC accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter Health of Delaware, Ambetter from Absolute Total Care and Ambetter from Arizona Complete Health and 51 other insurers list Northtown Pharmacy LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Northtown Pharmacy LLC was last updated on July 7, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.