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General NPI Number Information
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NPI Number | 1053337444
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Entity Type | Organization
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Legal Business Name | J L & C ENTERPRISES INC
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Dates
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Enumeration Date | 07/15/2006
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Last Update Date | 08/26/2008
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Provider Practice Location Address
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Address Line | 406 W GOODWIN ST
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City | PRESCOTT
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State | AZ
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Zip | 86303-3737
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Country | US
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Telephone | 928-445-3550
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Fax |
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Provider Business Mailing Address
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Address Line | 406 W GOODWIN ST
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City | PRESCOTT
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State | AZ
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Zip | 86303-3737
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Country | US
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Telephone | 928-445-3550
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Fax |
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Authorized Official
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Title or Position | PHARMACIST OWNER
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Name | JOHN PHILLIPS
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Credential | RPH
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Telephone | 928-445-3550
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 2295
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License Number State | AZ
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