Healthcare Provider Details

I. General information

NPI: 1598399040
Provider Name (Legal Business Name): DJS PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/24/2020
Last Update Date: 07/14/2020
Certification Date: 07/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4222 NW CARY PKWY
CARY NC
27513-8411
US

IV. Provider business mailing address

4222 NW CARY PKWY
CARY NC
27513-8411
US

V. Phone/Fax

Practice location:
  • Phone: 919-377-0342
  • Fax: 919-377-0349
Mailing address:
  • Phone: 919-377-0342
  • Fax: 919-377-0349

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: JIN LEE
Title or Position: MEMBER/OWNER
Credential: PHARM D
Phone: 919-799-0351