Organization Name: | TJD ENTERPRISES, LLC |
NPI Number: | 1477843670 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CHARLES DOEHRING (CO-MANAGER) |
Mailing Address: | 18195 Eula Mae Pkwy Carlyle |
State: | IL US |
Postal Code: | 622316406 |
Phone Number: | 6185948385 |
Fax Number: | 6185948591 |
NPI Enumeration Date: | 04/10/2011 |
NPI Last Update Date: | 12/22/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 3336C0004X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Pharmacy |
Taxonomy Specialization: | Compounding Pharmacy |
Taxonomy Definition: | A pharmacy that specializes in the preparation of components into a drug preparation as the result of a Practitioner |