Healthcare Provider Details

I. General information

NPI: 1003987140
Provider Name (Legal Business Name): THEJUS CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/12/2006
Last Update Date: 12/18/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3343 FULTON ST
BROOKLYN NY
11208-2003
US

IV. Provider business mailing address

3343 FULTON ST
BROOKLYN NY
11208-2003
US

V. Phone/Fax

Practice location:
  • Phone: 718-277-5371
  • Fax: 718-277-9836
Mailing address:
  • Phone: 718-277-5371
  • Fax: 718-277-9836

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number016582
License Number StateNY

VIII. Authorized Official

Name: CHANDRAMOHAN HARANHALLI
Title or Position: PRES AND SUPERV PHARMACIST
Credential: MS
Phone: 718-277-5371