Healthcare Provider Details

I. General information

NPI: 1851002976
Provider Name (Legal Business Name): DJI PHARMACY SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2022
Last Update Date: 12/09/2022
Certification Date: 12/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12025 ROJAS DR STE I
EL PASO TX
79936-7721
US

IV. Provider business mailing address

12025 ROJAS DR STE I
EL PASO TX
79936-7721
US

V. Phone/Fax

Practice location:
  • Phone: 915-910-7070
  • Fax: 915-910-4607
Mailing address:
  • Phone: 915-910-7070
  • Fax: 915-910-4607

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number State

VIII. Authorized Official

Name: DANIEL J. IRWIN
Title or Position: OWNER
Credential: PHARMACISTS
Phone: 915-910-7070