Provider Demographics
NPI:1790703619
Name:L & J PHARMACIES INC
Entity Type:Organization
Organization Name:L & J PHARMACIES INC
Other - Org Name:KING'S PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:DOUGLAS
Authorized Official - Last Name:PLUNK
Authorized Official - Suffix:SR
Authorized Official - Credentials:RPH
Authorized Official - Phone:409-983-3384
Mailing Address - Street 1:1948 9TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORT ARTHUR
Mailing Address - State:TX
Mailing Address - Zip Code:77642-2762
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1948 9TH AVE
Practice Address - Street 2:
Practice Address - City:PORT ARTHUR
Practice Address - State:TX
Practice Address - Zip Code:77642-2762
Practice Address - Country:US
Practice Address - Phone:409-983-3384
Practice Address - Fax:409-982-2826
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-18
Last Update Date:2008-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX05450183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX4510322 (141910)Medicaid
TX4510322OtherNABP(NCCPD)
TX4510322 (141910)Medicaid
TX4510322OtherNABP(NCCPD)