Provider Type Icon

DEJACE ENTERPRISES INC NPI 1861488660


NPI Information

NPI: 1861488660
Provider Name: DEJACE ENTERPRISES INC
Classification: Pharmacy - 3336C0003X
Entity Type: Organization

Specialization: Community/Retail Pharmacy

Address:
106A BROADWAY ST
ELSBERRY, MO
ZIP 63343
Phone: (573) 898-2550
Get Directions

DEJACE ENTERPRISES INC is a community/retail pharmacy pharmacy in Elsberry, MO. The provider is 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. DEJACE ENTERPRISES INC NPI is 1861488660. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

106A BROADWAY ST
ELSBERRY, MO
ZIP 63343-233
Phone: (573) 898-2550
Fax: (573) 898-5730

The provider's authorized official is Andrew Osterkamp .
The authorized official title is Pharmacist and has the following contact phone number (573) 898-2550.

The enumeration date for this NPI number is 9/27/2005 and was last updated on 2/14/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1163WD0400XRegistered NurseDiabetes EducatorNo
2332B00000XDurable Medical Equipment & Medical Supplies029059MISSOURINo
3333600000XPharmacy029059MISSOURINo
43336C0003XPharmacyCommunity/Retail PharmacyYes
53336L0003XPharmacyLong Term Care PharmacyNo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1601684608MEDICAIDMISSOURI
262184604MEDICAIDMISSOURI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.