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General NPI Number Information
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NPI Number | 1043230485
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Entity Type | Organization
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Legal Business Name | EJJE, INC
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Dates
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Enumeration Date | 07/20/2006
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Last Update Date | 11/06/2020
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Provider Practice Location Address
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Address Line | 2315 ASHEVILLE HWY SUITE 50
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City | HENDERSONVILLE
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State | NC
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Zip | 28791-1500
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Country | US
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Telephone | 828-692-1022
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Fax | 828-698-1572
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Provider Business Mailing Address
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Address Line | 2315 ASHEVILLE HWY SUITE 50
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City | HENDERSONVILLE
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State | NC
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Zip | 28791-1500
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Country | US
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Telephone | 828-692-1022
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Fax | 828-698-1572
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. LARRY JACKSON SHELTON
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Credential | RPH
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Telephone | 828-692-1022
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 4058
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License Number State | NC
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