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General NPI Number Information
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NPI Number | 1144470642
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Entity Type | Organization
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Legal Business Name | K J PHARMACY, INC
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Dates
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Enumeration Date | 09/22/2008
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Last Update Date | 10/07/2008
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Provider Practice Location Address
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Address Line | 900 E ASHBY RD
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City | QUINBY
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State | SC
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Zip | 29506-7323
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Country | US
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Telephone | 843-389-2731
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Fax | 843-389-4199
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Provider Business Mailing Address
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Address Line | 900 E ASHBY RD
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City | QUINBY
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State | SC
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Zip | 29506-7323
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Country | US
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Telephone | 843-389-2731
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Fax | 843-389-4199
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. GREGORY FISHER
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Credential |
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Telephone | 843-389-2731
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 50010151
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License Number State | SC
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