Organization
JAYHAWK HOLDINGS INC
Active
Other names
Milly's Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DEBORAH R KEAVENY RPH (CONTRACT MANAGER)
(612) 227-7811
Entity
Organization
Contact information
Practice address
2626 FEDERAL ST, CAMDEN, NJ 08105-1936
(856) 963-0300
(856) 963-2202
Mailing address
2626 FEDERAL ST, CAMDEN, NJ 08105-1936
(856) 963-0300
(856) 963-2202
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
28RS00693000
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0242764
—
NJ
01
—
0242781
MEDICAID DME
NJ
01
—
3135034
NCPDP #
—
Enumeration date
10/04/2006
Last updated
11/30/2010
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