Provider Demographics
NPI:1619003027
Name:AMJ PRODUCTS LLC
Entity Type:Organization
Organization Name:AMJ PRODUCTS LLC
Other - Org Name:KUSLERS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CO OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JANET
Authorized Official - Middle Name:
Authorized Official - Last Name:KUSLER
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:360-568-7787
Mailing Address - Street 1:700 AVENUE D
Mailing Address - Street 2:
Mailing Address - City:SNOHOMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98290-2333
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:700 AVENUE D
Practice Address - Street 2:
Practice Address - City:SNOHOMISH
Practice Address - State:WA
Practice Address - Zip Code:98290-2333
Practice Address - Country:US
Practice Address - Phone:360-568-7787
Practice Address - Fax:360-568-3626
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2008-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X, 3336C0004X
WACF000563993336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
4927022OtherOTHER ID NUMBER
WA6022297Medicaid
4927022OtherOTHER ID NUMBER-COMMERCIAL NUMBER
4927022OtherOTHER ID NUMBER