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General NPI Number Information
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NPI Number | 1154461309
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Entity Type | Organization
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Legal Business Name | PEJ INC
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Dates
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Enumeration Date | 02/07/2007
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Last Update Date | 08/14/2008
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Provider Practice Location Address
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Address Line | 95 JACKSON HEIGHTS
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City | JACKSON
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State | KY
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Zip | 41339
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Country | US
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Telephone | 606-666-5500
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Fax | 606-666-5581
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Provider Business Mailing Address
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Address Line | 95 JACKSON HEIGHTS
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City | JACKSON
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State | KY
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Zip | 41339
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Country | US
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Telephone | 606-666-5500
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Fax | 606-666-5581
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Authorized Official
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Title or Position | OWNER
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Name | MR. EVERETT L DUNAWAY
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Credential | RPH.
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Telephone | 606-666-5500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | P06982
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License Number State | KY
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