DJK 36 INC (NPI# 1386949550) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386949550 |
| Entity Type | Organization |
| Organization Name | DJK 36 INC |
| Other Organization Name | MONTEZUMA DRUG COMPANY |
| Practice Address |
112 S Dooly St Montezuma GA 31063-1604 |
| Mailing Address |
Po Box 250 Montezuma GA 31063-0250 |
| Practice Telephone | 4784727561 |
| Practice Fax Number | 4784725887 |
| Mailing Telephone | 4784727561 |
| Mailing Fax Number | 4784725887 |
| Enumeration Date | 2011-01-20 |
| Last Update Date | 2011-05-09 |
| Authorized Official Name | DANIEL KISER (PHARMACIST IN CHARGE/OWNER) |
| Authorized Official Telephone | 4784727561 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
PHRE003393 | GA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NCPDP PROVIDER IDENTIFICATION NUMBER | 1161063 | 01 | |
| GA | 00927649A | 05 |
| Other Name | Type Code |
|---|---|
| Montezuma Drug Company | Doing Business As Name - Organization |
| Street Address |
112 S DOOLY ST |
| City | MONTEZUMA |
| State | GA |
| Zip Code | 31063-1604 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508838327 | Donald Keith Lane | Pharmacist | 112 S Dooly St, Montezuma, GA 31063-1604 | 2006-02-06 |
| 1235201138 | John D Hames | Pharmacist | 112 S Dooly St, Montezuma, GA 31063 | 2006-11-15 |
| 1104881556 | Dkl31092 Inc | Pharmacy | 112 S Dooly St, Montezuma, GA 31063-1604 | 2006-04-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184240939 | Elizabeth Cupp Greene | Nurse Practitioner | 506c Spaulding Road, Suite B, Montezuma, GA 31063 | 2020-06-17 |
| 1013308311 | Margo Renee Gaskins | Nurse Practitioner | 506 C Spaulding Rd, Suite B, Montezuma, GA 31063 | 2015-02-09 |
| 1407252638 | Careconnect Health, Inc. | Clinic/Center | 506-c Spaulding Road, Suite B, Montezuma, GA 31063 | 2014-11-17 |
| 1861802134 | Freds Stores of Tennessee Inc | Pharmacy | 201 Walnut Street, Montezuma, GA 31063 | 2014-05-07 |
| 1588093637 | Premier Healthcare Investments | Medicare Defined Swing Bed Unit | 509 Sumter, Montezuma, GA 31063 | 2013-11-08 |
| 1194873661 | Charlene Marie Hanson | Nurse Practitioner | Flint River Hospital, 509 Sumpter Street, Montezuma, GA 31063 | 2007-01-08 |
| 1093888687 | Quincy Jerome Jordan Sr. | Family Medicine | 509 Sumter St, Montezuma, GA 31063 | 2006-11-15 |
| 1073129896 | Lotus Nest Counseling Services LLC | Marriage & Family Therapist | 906 Weathers Dr, Montezuma, GA 31063-1016 | 2020-09-17 |
| 1609408319 | Lucille Brown | Social Worker | 902 June Dr, Montezuma, GA 31063-1021 | 2020-02-10 |
| 1083246797 | J & M Serene Care, LLC | Day Training, Developmentally Disabled Services | 902 June Dr, Montezuma, GA 31063-1021 | 2020-02-11 |
| Find all providers in zip 31063 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144844168 | J & J Rx LLC | Pharmacy | 212 N Dooly St, Montezuma, GA 31063-1510 | 2020-06-05 |
| 1447778253 | Nudak Ventures LLC | Pharmacy | 323 E Main Street, Montezuma, IA 50171 | 2017-08-31 |
| 1861802134 | Freds Stores of Tennessee Inc | Pharmacy | 201 Walnut Street, Montezuma, GA 31063 | 2014-05-07 |
| 1871759662 | Remedy Drug Inc | Pharmacy | 323 E Main, Montezuma, IA 50171 | 2008-08-01 |
| 1073616819 | Georgia Cvs Pharmacy LLC | Pharmacy | 501 Spaulding Rd, Montezuma, GA 31063-1803 | 2006-09-07 |
| 1205329943 | Doctor's Pharmacy-vital Care, Inc. | Pharmacy | 116 Walnut St, Montezuma, GA 31063-1903 | 2018-06-07 |
| 1851712376 | Monte Pharmacies LLC | Pharmacy | 323 East Main Street, Montezuma, IA 50171 | 2013-12-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154922441 | Southern Pharmacy Group LLC | Pharmacy | 110 Allison St., Jesup, GA 31545 | 2020-11-04 |
| 1184225526 | Svdp Georgia Community Pharmacy LLC | Pharmacy | 2050 Chamblee Tucker Rd Ste C, Chamblee, GA 30341-3343 | 2020-11-03 |
| 1194325860 | Panola Pharmacy LLC | Pharmacy | 2348 Panola Rd Unit C, Lithonia, GA 30058-5406 | 2020-10-30 |
| 1659971539 | Bob and Jeff's Hometown Pharmacy of Thomasville, LLC | Pharmacy | 309 Smith Ave, Thomasville, GA 31792-5534 | 2020-10-29 |
| 1679171979 | Dfg LLC | Pharmacy | 638 Historic Hwy 441 Suite A, Demorest, GA 30530 | 2020-10-09 |
| 1033716915 | Au Medical Center, Inc. | Pharmacy | 818 Saint Sebastian Way Ste 402, Augusta, GA 30901-2654 | 2020-10-05 |
| 1043817208 | Mlk Pharmacy2.0 | Pharmacy | 2457 Mlk Jr Dr Sw Ste A, Atlanta, GA 30311-1712 | 2020-10-01 |
| 1508470964 | Swain Drug Company LLC | Pharmacy | 855 Bowens Mill Rd Sw Suite E, Douglas, GA 31533 | 2020-09-03 |
| 1205446341 | Sunny Pharmacy | Pharmacy | 5364 Jonesboro Rd, Lake City, GA 30260-3557 | 2020-08-04 |
| 1841818044 | Hospital Authority of Miller County | Pharmacy | 213 Delores Street, Colquitt, GA 39837 | 2020-07-14 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.