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Organization
ACJK INC
Active
Organization
ACJK INC
Active
Other names
Medicap Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ALBERT DANIEL PELATE RPH (OWNER MANAGER)
(618) 451-8001
Entity
Organization
Contact information
Practice address
2770 MADISON AVE, GRANITE CITY, IL 62040-3607
(618) 451-8001
(618) 451-8015
Mailing address
2770 MADISON AVE, GRANITE CITY, IL 62040-3607
(618) 451-8001
(618) 451-8015
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
54014022
IL
333600000X
Pharmacy
54014022
IL
3336C0003X
Community/Retail Pharmacy
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1469736
NABP
—
Enumeration date
08/17/2005
Last updated
03/07/2023
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