Provider Demographics
NPI:1205373305
Name:J&J PHARMACY INC
Entity Type:Organization
Organization Name:J&J PHARMACY INC
Other - Org Name:J&J PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMIN ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:KITCHENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-779-7000
Mailing Address - Street 1:4055 AL HIGHWAY 9 STE G
Mailing Address - Street 2:
Mailing Address - City:CEDAR BLUFF
Mailing Address - State:AL
Mailing Address - Zip Code:35959-5099
Mailing Address - Country:US
Mailing Address - Phone:706-777-3373
Mailing Address - Fax:
Practice Address - Street 1:1 ALABAMA ST
Practice Address - Street 2:
Practice Address - City:CAVE SPRING
Practice Address - State:GA
Practice Address - Zip Code:30124-2611
Practice Address - Country:US
Practice Address - Phone:706-777-3373
Practice Address - Fax:706-777-3374
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-26
Last Update Date:2019-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPHRE010335333600000X
3336C0003X, 3336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2167379OtherPK