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General NPI Number Information
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NPI Number | 1356450134
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Entity Type | Organization
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Legal Business Name | JJM ENTERPRISES INC. , DBA GEM PHARMACY
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Dates
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Enumeration Date | 08/29/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 191 E ORCHARD RD SUITE #100
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City | LITTLETON
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State | CO
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Zip | 80121-8000
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Country | US
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Telephone | 303-795-3154
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Fax | 303-795-0406
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Provider Business Mailing Address
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Address Line | 191 E ORCHARD RD SUITE #100
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City | LITTLETON
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State | CO
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Zip | 80121-8000
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Country | US
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Telephone | 303-795-3154
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Fax | 303-795-0406
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | MR. KENNETH COOK OWEN
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Credential | R.PH.
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Telephone | 303-795-3154
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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 | 370000003
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License Number State | CO
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