Provider Demographics
NPI:1467893370
Name:D & J DRUGS, INC.
Entity Type:Organization
Organization Name:D & J DRUGS, INC.
Other - Org Name:KENANSVILLE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:COOPER
Authorized Official - Last Name:BYRD
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:910-296-0500
Mailing Address - Street 1:134 LIBERTY SQUARE
Mailing Address - Street 2:SUITE B
Mailing Address - City:KENANSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28349
Mailing Address - Country:US
Mailing Address - Phone:919-296-0500
Mailing Address - Fax:910-296-0515
Practice Address - Street 1:134 LIBERTY SQUARE
Practice Address - Street 2:SUITE B
Practice Address - City:KENANSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28349
Practice Address - Country:US
Practice Address - Phone:910-296-0500
Practice Address - Fax:910-296-0515
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:D & J DRUGS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-07-09
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 332BC3200X
NC11577333600000X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3461706OtherNCPDP
NCQ454590001OtherMEDICARE FLU PTAN
NC11577OtherPHARMACY PERMIT