Healthcare Provider Details

I. General information

NPI: 1588524532
Provider Name (Legal Business Name): UNIVERSAL J&E ENTERPRISES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2025
Last Update Date: 11/13/2025
Certification Date: 11/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34 US HIGHWAY 68 E UNIT A
BENTON KY
42025-8336
US

IV. Provider business mailing address

817 MAIN ST
BENTON KY
42025-1240
US

V. Phone/Fax

Practice location:
  • Phone: 270-527-3135
  • Fax: 270-410-1191
Mailing address:
  • Phone: 270-527-3135
  • Fax: 270-410-1191

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: AMBER LYNN MANNING
Title or Position: PHARMACIST
Credential: PHARMD
Phone: 270-527-3135