Healthcare Provider Details

I. General information

NPI: 1871267575
Provider Name (Legal Business Name): JPM PHARMACIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2021
Last Update Date: 08/05/2021
Certification Date: 08/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3408 N 1ST AVE
EVANSVILLE IN
47710-3302
US

IV. Provider business mailing address

3408 N 1ST AVE
EVANSVILLE IN
47710-3302
US

V. Phone/Fax

Practice location:
  • Phone: 812-422-8255
  • Fax: 812-422-6329
Mailing address:
  • Phone: 812-422-8255
  • Fax: 812-422-6329

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: JACOB P MAYER
Title or Position: OWNER
Credential: PHARMD
Phone: 812-422-8255