NPI 1093707903 · live from the CMS NPI Registry
Acjk INC
Pharmacy, Community/Retail Pharmacy in Granite City, IL. National Provider Identifier 1093707903, active.
NPI record
| NPI | 1093707903 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Pharmacy, Community/Retail Pharmacy 3336C0003X |
| Practice location | 2770 Madison Ave, Granite City, IL 62040 |
| Practice phone | 618-451-8001 |
| Enumerated | August 17, 2005 |
| Last updated | March 7, 2023 |
| Authorized official | Albert Pelate, Owner Manager |
| Other names | Medicap Pharmacy |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | 54014022 (IL) |
| Pharmacy | 333600000X | 54014022 (IL) |
| Pharmacy, Community/Retail Pharmacy primary | 3336C0003X | — (IL) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.