Healthcare Provider Details

I. General information

NPI: 1659478576
Provider Name (Legal Business Name): J & P HOLDING COMPANY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 10/02/2020
Certification Date: 10/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

611 PARK AVE
PLAINFIELD NJ
07060-1612
US

IV. Provider business mailing address

611 PARK AVE
PLAINFIELD NJ
07060-1612
US

V. Phone/Fax

Practice location:
  • Phone: 908-756-0008
  • Fax: 908-668-8630
Mailing address:
  • Phone: 908-756-0008
  • Fax: 908-668-8630

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number28RS00635400
License Number StateNJ

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier0137723
Identifier TypeMEDICAID
Identifier StateNJ
Identifier Issuer
# 2
Identifier2054182
Identifier TypeOTHER
Identifier State
Identifier IssuerPK

VIII. Authorized Official

Name: HITESH PATEL
Title or Position: PRESIDENT
Credential: RPH
Phone: 732-593-7020