Provider Demographics
NPI:1922353499
Name:CJ PHARMACY INFUSIONS, LLC
Entity Type:Organization
Organization Name:CJ PHARMACY INFUSIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CASSANDRA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:BEHRENDS
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:970-526-9418
Mailing Address - Street 1:PO BOX 531
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:CO
Mailing Address - Zip Code:80751-0531
Mailing Address - Country:US
Mailing Address - Phone:970-526-9418
Mailing Address - Fax:970-522-7589
Practice Address - Street 1:422 MAIN ST
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:CO
Practice Address - Zip Code:80751-4343
Practice Address - Country:US
Practice Address - Phone:970-526-9418
Practice Address - Fax:970-522-7589
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CJ PHARMACY SERVICES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-07-19
Last Update Date:2012-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPDO-8073336H0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO4605290001Medicaid
6505290001Medicare PIN