MEDICARE: JACOB PHARMACY INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0003X	Community/Retail Pharmacy

General Provider Information

NPI Number	:	1033831193
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JACOB PHARMACY INC.

Provider Business Mailing Address
First Line	:	1106 SAINT JOHNS PL
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11213-2699
Country	:	US
Telephone Number	:	718-221-4805
Fax Number	:	718-221-4811

Provider Business Practice Location Address
First Line	:	1106 SAINT JOHNS PL
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11213-2699
Country	:	US
Telephone Number	:	718-221-4805
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	RIBI ARONOV
Credential	:
Telephone Number	:	718-221-4805

Provider Enumeration Date	:	09/15/2022
Last Update Date	:	12/05/2025

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