Provider Demographics
NPI:1215045539
Name:J&J PHARMACY INC
Entity Type:Organization
Organization Name:J&J PHARMACY INC
Other - Org Name:MILLER PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP
Authorized Official - Prefix:
Authorized Official - First Name:JILL
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:641-585-3931
Mailing Address - Street 1:PO BOX 169
Mailing Address - Street 2:
Mailing Address - City:FOREST CITY
Mailing Address - State:IA
Mailing Address - Zip Code:50436-0169
Mailing Address - Country:US
Mailing Address - Phone:641-585-3931
Mailing Address - Fax:641-585-1783
Practice Address - Street 1:635 E US HIGHWAY 9
Practice Address - Street 2:
Practice Address - City:FOREST CITY
Practice Address - State:IA
Practice Address - Zip Code:50436-1028
Practice Address - Country:US
Practice Address - Phone:641-585-3931
Practice Address - Fax:641-585-1783
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-27
Last Update Date:2017-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X, 3336L0003X
IA3383336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0137810Medicaid
2026553OtherPK
1110760001Medicare NSC