Provider Demographics
NPI:1144470642
Name:K J PHARMACY, INC
Entity type:Organization
Organization Name:K J PHARMACY, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:
Authorized Official - Last Name:FISHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-389-2731
Mailing Address - Street 1:900 E ASHBY RD
Mailing Address - Street 2:
Mailing Address - City:QUINBY
Mailing Address - State:SC
Mailing Address - Zip Code:29506-7323
Mailing Address - Country:US
Mailing Address - Phone:843-389-2731
Mailing Address - Fax:843-389-4199
Practice Address - Street 1:900 E ASHBY RD
Practice Address - Street 2:
Practice Address - City:QUINBY
Practice Address - State:SC
Practice Address - Zip Code:29506-7323
Practice Address - Country:US
Practice Address - Phone:843-389-2731
Practice Address - Fax:843-389-4199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-22
Last Update Date:2008-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC500101513336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy