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General NPI Number Information
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NPI Number | 1285924431
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Entity Type | Organization
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Legal Business Name | T&J ENTERPRISE LLC
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Dates
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Enumeration Date | 04/08/2011
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Last Update Date | 03/17/2017
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Provider Practice Location Address
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Address Line | 1630 OHIO ST
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City | AUGUSTA
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State | KS
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Zip | 67010-2142
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Country | US
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Telephone | 316-262-2001
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Fax | 316-775-3469
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Provider Business Mailing Address
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Address Line | 1630 OHIO ST
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City | AUGUSTA
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State | KS
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Zip | 67010-2142
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Country | US
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Telephone | 316-775-3714
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Fax | 316-775-3469
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Authorized Official
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Title or Position | OWNER/MGR
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Name | JEFFREY HILGERS
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Credential | RPH
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Telephone | 316-253-4384
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 2-10334
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License Number State | KS
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