Healthcare Provider Details

I. General information

NPI: 1619003027
Provider Name (Legal Business Name): AMJ PRODUCTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2007
Last Update Date: 07/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 AVENUE D
SNOHOMISH WA
98290-2333
US

IV. Provider business mailing address

700 AVENUE D
SNOHOMISH WA
98290-2333
US

V. Phone/Fax

Practice location:
  • Phone: 360-568-7787
  • Fax: 360-568-3626
Mailing address:
  • Phone:
  • Fax:

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 NumberCF00056399
License Number StateWA
# 4
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: JANET KUSLER
Title or Position: CO OWNER
Credential: RPH
Phone: 360-568-7787