Organization
L&J PHARMACY INC
Active
Other names
Mom and Pop Drug #1 Specialty
Organization subpart
No
Provider details
NPI number
Authorized official
JIM COKER (OWNER)
(417) 459-1436
Entity
Organization
Contact information
Practice address
319 S MAIN ST STE N-2, ROGERSVILLE, MO 65742-9361
(417) 753-7774
(417) 753-7786
Mailing address
PO BOX 260, ROGERSVILLE, MO 65742-0260
(417) 753-7774
(417) 753-7786
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
2013045671
MO
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2143040
PK
—
Enumeration date
12/23/2013
Last updated
02/13/2014
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