Healthcare Provider Details

I. General information

NPI: 1497928832
Provider Name (Legal Business Name): JSK FAMILY PHARMACIES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/07/2008
Last Update Date: 04/21/2022
Certification Date: 04/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8010 2ND ST
PARAMOUNT CA
90723-3404
US

IV. Provider business mailing address

8010 2ND ST
PARAMOUNT CA
90723-3404
US

V. Phone/Fax

Practice location:
  • Phone: 562-531-1313
  • Fax:
Mailing address:
  • Phone: 562-531-1313
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPHY 50389
License Number StateCA

VIII. Authorized Official

Name: MINESH BHAKTA
Title or Position: PRESIDENT
Credential:
Phone: 562-531-1313