Provider Demographics
NPI:1689655250
Name:S.GJ&P INC
Entity Type:Organization
Organization Name:S.GJ&P INC
Other - Org Name:JOHNNYS DRUGS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:FUSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-597-7822
Mailing Address - Street 1:PO BOX 299
Mailing Address - Street 2:
Mailing Address - City:SMITHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37166-0299
Mailing Address - Country:US
Mailing Address - Phone:615-597-7822
Mailing Address - Fax:615-597-1112
Practice Address - Street 1:516B W MAIN ST
Practice Address - Street 2:
Practice Address - City:SMITHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37166-1118
Practice Address - Country:US
Practice Address - Phone:615-597-7822
Practice Address - Fax:615-597-1112
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-09
Last Update Date:2022-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN9449808Medicaid
TN4427313OtherNCPDP
TN9449808Medicaid