Organization Name: | DEJACE ENTERPRISES INC |
NPI Number: | 1861488660 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JERRY CALLAHAN (OWNER PHARMACIST) |
Mailing Address: | 106a Broadway St Elsberry |
State: | MO US |
Postal Code: | 633431233 |
Phone Number: | 5738982550 |
Fax Number: | 5738985730 |
NPI Enumeration Date: | 09/27/2005 |
NPI Last Update Date: | 03/04/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 333600000X |
License Number: | 029059 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MO |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Pharmacy |
Taxonomy Specialization: | |
Taxonomy Definition: | A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |