Provider Demographics
NPI:1922427897
Name:EJ&K ENTERPRISE LLC
Entity Type:Organization
Organization Name:EJ&K ENTERPRISE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:V.P
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMAR
Authorized Official - Middle Name:D
Authorized Official - Last Name:HOOKS
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:330-962-7437
Mailing Address - Street 1:247 S BALCH ST
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44302-1647
Mailing Address - Country:US
Mailing Address - Phone:330-962-7437
Mailing Address - Fax:234-208-8262
Practice Address - Street 1:247 S BALCH ST
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44302-1647
Practice Address - Country:US
Practice Address - Phone:330-962-7437
Practice Address - Fax:234-208-8262
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-08
Last Update Date:2014-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service