Organization
KJAA INC
Active
Other names
Medicap Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER LYN STALLMAN (MANAGER OWNER)
(641) 236-3663
Entity
Organization
Contact information
Practice address
320 6TH AVE, GRINNELL, IA 50112-1845
(641) 236-3663
(641) 236-0260
Mailing address
320 6TH AVE, GRINNELL, IA 50112-1845
(641) 236-3663
(641) 236-0260
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
537
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0423228
—
IA
01
—
1621778
NCPDP #
IA
Enumeration date
05/24/2006
Last updated
03/07/2023
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