Healthcare Provider Details

I. General information

NPI: 1922322890
Provider Name (Legal Business Name): RJ PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2010
Last Update Date: 10/30/2024
Certification Date: 10/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2111 WILLIAMSBRIDGE RD
BRONX NY
10461-1601
US

IV. Provider business mailing address

2111 WILLIAMSBRIDGE RD
BRONX NY
10461-1601
US

V. Phone/Fax

Practice location:
  • Phone: 347-691-3701
  • Fax: 347-691-3704
Mailing address:
  • Phone: 347-691-3701
  • Fax: 347-691-3704

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 Number029982
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: JASMINA INCEKARA
Title or Position: MANAGER
Credential:
Phone: 347-691-3701