Organization
DMMJR INC
Active
Other names
DMK Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTINA R JOHNSON (PRESIDENT)
(619) 722-6442
Entity
Organization
Contact information
Practice address
1730 ALPINE BLVD STE 109, ALPINE, CA 91901-3877
(619) 722-6442
(619) 722-6443
Mailing address
1730 ALPINE BLVD STE 109, ALPINE, CA 91901-3877
(619) 722-6442
(619) 722-6443
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
PHY51950
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1124560941
—
CA
01
—
2166108
PK
—
Enumeration date
11/10/2016
Last updated
03/21/2022
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