1215601620 NPI number — S&J PHARMA CONSULTING LLC

Table of content: (NPI 1215601620)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1215601620 NPI number — S&J PHARMA CONSULTING LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
S&J PHARMA CONSULTING LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1215601620
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/09/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1435 RED WOLF DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ROCKWALL
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75087-7380
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
419-234-8384
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2137 DIXIE HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LOUISVILLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40210-2242
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-414-7788
Provider Business Practice Location Address Fax Number:
859-757-2042
Provider Enumeration Date:
08/09/2021

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
BIRKEMEIER
Authorized Official First Name:
JACOB
Authorized Official Middle Name:
Authorized Official Title or Position:
MANAGING PARTNER
Authorized Official Telephone Number:
419-234-8384

Provider Taxonomy Codes

  • Taxonomy code: 261QM1200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)