Jackson Drug Co
Jackson Drug Co is a healthcare organization registered as Community/Retail Pharmacy in Jackson, MN, holding Type 2 (organization) NPI 1053456889 since 2007. The authorized official on file is Lance Edlin, Owner.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1053456889 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Jackson Drug Co |
| Other name | <Unavail> |
| Practice address | 506 2ND ST, Jackson, MN, 56143 |
| Phone | 5078473161 |
| Fax | 5078472480 |
| Enumeration date | 2007-02-20 |
| Last updated in NPPES | 2007-08-13 |
Authorized official
| Name | Lance Edlin |
|---|---|
| Title | Owner |
| Phone | 5078473161 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 332B00000X | Durable Medical Equipment & Medical Supplies | Secondary | — | — |
| 333600000X | Pharmacy | Secondary | 22124900 | MN |
| 3336C0004X | Compounding Pharmacy | Secondary | — | — |
| 3336L0003X | Long Term Care Pharmacy | Secondary | — | — |
| 3336M0003X | Managed Care Organization Pharmacy | Secondary | — | — |
| 3336C0003X | Community/Retail Pharmacy | Primary | — | — |
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2405632 | Other | — | OTHER ID NUMBER-COMMERCIAL NUMBER |
Copy-ready billing details
Provider: Jackson Drug Co NPI: 1053456889 Taxonomy: 3336C0003X (Community/Retail Pharmacy) Address: 506 2ND ST, Jackson, MN, 56143
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1083896716 | Shopko Stores Operating Co LLC | Organization | Community/Retail Pharmacy | Jackson, MN |
Verify this record
Cross-check NPI 1053456889 against the authoritative CMS record: view Jackson Drug Co on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
What type of organization is Jackson Drug Co?
What is a Type 2 NPI?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2007-08-13.