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Contact Information

DEJACE ENTERPRISES INC
106A BROADWAY ST
ELSBERRY, MO63343-1233
 Phone: 573-898-2550
 Fax: 573-898-5730
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
 

Diabetes Educator

163WD0400X
 

Durable Medical Equipment & Medical Supplies

332B00000X 54 Other Medical Supply Company
 

Long Term Care Pharmacy

3336L0003X 58 Medical Supply Company with Pharmacist
 

Pharmacy

333600000X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for DEJACE ENTERPRISES INC

NPI # 1861488660
LBN Legal business name DEJACE ENTERPRISES INC
Authorized official ANDREW OSTERKAMP - (PHARMACIST)
Entity Organization
Organization subpart 1 No
Enumeration date 09/27/2005
Last updated 02/14/2020 - About 6 years ago
Identifiers
MO License # 029059
MO Medicaid 601684608
MO Medicaid 62184604
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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