Healthcare Provider Details

I. General information

NPI: 1689978645
Provider Name (Legal Business Name): JOJAN PHARMA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2011
Last Update Date: 10/27/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 SAINT NICHOLAS AVE
BROOKLYN NY
11237-4043
US

IV. Provider business mailing address

121 SAINT NICHOLAS AVE
BROOKLYN NY
11237-4043
US

V. Phone/Fax

Practice location:
  • Phone: 201-780-7210
  • Fax:
Mailing address:
  • Phone:
  • Fax:

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 Number17-030756
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number17-030756
License Number StateNY

VIII. Authorized Official

Name: RATHNA VEERAMACHANANI
Title or Position: PRESIDENT
Credential:
Phone: 201-780-7210