Organization
DJK 36 INC
Active
Other names
Montezuma Drug Company
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL KISER (PHARMACIST IN CHARGE/OWNER)
(478) 472-7561
Entity
Organization
Contact information
Practice address
112 S DOOLY ST, MONTEZUMA, GA 31063-1604
(478) 472-7561
(478) 472-5887
Mailing address
PO BOX 250, MONTEZUMA, GA 31063-0250
(478) 472-7561
(478) 472-5887
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHRE003393
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00927649A
—
GA
01
—
1161063
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
01/20/2011
Last updated
05/09/2011
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up