Provider Demographics
NPI:1881975118
Name:E & J PHARMACY, INC.
Entity type:Organization
Organization Name:E & J PHARMACY, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EFFIE
Authorized Official - Middle Name:
Authorized Official - Last Name:WILKERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-455-8900
Mailing Address - Street 1:1313 HOLLAND ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77029-2890
Mailing Address - Country:US
Mailing Address - Phone:713-455-8900
Mailing Address - Fax:713-455-8902
Practice Address - Street 1:1313 HOLLAND ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77029-2890
Practice Address - Country:US
Practice Address - Phone:713-455-8900
Practice Address - Fax:713-455-8902
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-31
Last Update Date:2011-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX273713336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
5903908OtherNCPDP PROVIDER IDENTIFICATION NUMBER