Organization
JJJ ENTERPRISES INC
Active
Other names
MEDICINE SHOPPE
Organization subpart
No
Provider details
NPI number
Authorized official
DENA FERMAN (THIRD PARTY PLAN COORDINATOR)
(314) 993-6000
Entity
Organization
Contact information
Practice address
107 PARK AVE, FALLS CHURCH, VA 22046-4308
(703) 536-4042
(703) 536-4432
Mailing address
107 PARK AVE, FALLS CHURCH, VA 22046-4308
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
0201001838
VA
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4816990
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
8513201
—
VA
Enumeration date
08/12/2005
Last updated
03/07/2023
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