Healthcare Provider Details

I. General information

NPI: 1215045539
Provider Name (Legal Business Name): J&J PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2006
Last Update Date: 04/28/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

635 E US HIGHWAY 9
FOREST CITY IA
50436-1028
US

IV. Provider business mailing address

PO BOX 169
FOREST CITY IA
50436-0169
US

V. Phone/Fax

Practice location:
  • Phone: 641-585-3931
  • Fax: 641-585-1783
Mailing address:
  • Phone: 641-585-3931
  • Fax: 641-585-1783

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number338
License Number StateIA
# 4
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: JILL MILLER
Title or Position: VP
Credential:
Phone: 641-585-3931