Provider Demographics
NPI:1154712974
Name:BLUEJAY PHARMACY, LLC
Entity type:Organization
Organization Name:BLUEJAY PHARMACY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, VICE PRESIDENT, PIC
Authorized Official - Prefix:DR
Authorized Official - First Name:KENDRA
Authorized Official - Middle Name:C
Authorized Official - Last Name:MCMULLIN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:281-251-0904
Mailing Address - Street 1:8344 SPRING CYPRESS RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379
Mailing Address - Country:US
Mailing Address - Phone:281-251-0904
Mailing Address - Fax:281-251-0905
Practice Address - Street 1:8344 SPRING CYPRESS RD
Practice Address - Street 2:SUITE A
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379
Practice Address - Country:US
Practice Address - Phone:281-251-0904
Practice Address - Fax:281-251-0905
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-16
Last Update Date:2015-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX297823336C0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0004XSuppliersPharmacyCompounding Pharmacy