Provider Demographics
NPI:1922019686
Name:J & J ENTERPRISES INC
Entity type:Organization
Organization Name:J & J ENTERPRISES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:701-244-5212
Mailing Address - Street 1:PO BOX 729
Mailing Address - Street 2:
Mailing Address - City:DUNSEITH
Mailing Address - State:ND
Mailing Address - Zip Code:58329-0729
Mailing Address - Country:US
Mailing Address - Phone:701-244-5212
Mailing Address - Fax:701-244-2242
Practice Address - Street 1:18 MAIN ST SW
Practice Address - Street 2:
Practice Address - City:DUNSEITH
Practice Address - State:ND
Practice Address - Zip Code:58329-0729
Practice Address - Country:US
Practice Address - Phone:701-244-5212
Practice Address - Fax:701-244-2242
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-10
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND1333336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND21115Medicaid
3504265OtherNCPDP
0741530002Medicare ID - Type Unspecified