Organization
TJD ENTERPRISES, LLC
Active
Other names
Med Plus Pharmacy of Carlyle
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES DOEHRING (CO-MANAGER)
(618) 327-3214
Entity
Organization
Contact information
Practice address
18195 EULA MAE PKWY, CARLYLE, IL 62231-6406
(618) 594-8385
(618) 594-8591
Mailing address
18195 EULA MAE PKWY, CARLYLE, IL 62231-6406
(618) 594-8385
(618) 594-8591
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
054.017720
IL
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1485792
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
04/10/2011
Last updated
12/22/2011
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