Provider Demographics
NPI:1972829364
Name:J & M ENDEAVORS, INC.
Entity Type:Organization
Organization Name:J & M ENDEAVORS, INC.
Other - Org Name:J & M DRUGS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:KENNEDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:478-731-9656
Mailing Address - Street 1:4851 RUSSELL PKWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31088-8696
Mailing Address - Country:US
Mailing Address - Phone:478-333-6652
Mailing Address - Fax:478-333-6752
Practice Address - Street 1:4851 RUSSELL PKWY
Practice Address - Street 2:SUITE 100
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31088-8696
Practice Address - Country:US
Practice Address - Phone:478-333-6652
Practice Address - Fax:478-333-6752
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-11
Last Update Date:2022-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPHRE0096513336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA278896668AMedicaid