Organization
KJ PHARMACY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN H SYMONS III (VP)
(843) 389-2731
Entity
Organization
Contact information
Practice address
240 KELLEY ST, LAKE CITY, SC 29560-2416
(843) 389-2731
Mailing address
PO BOX 1629, LAKE CITY, SC 29560-1629
(843) 389-2731
(843) 389-2776
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
15075
SC
3336C0003X
Community/Retail Pharmacy
Primary
15075
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
715075
—
SC
Enumeration date
04/27/2015
Last updated
04/27/2015
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