Healthcare Provider Details

I. General information

NPI: 1033106992
Provider Name (Legal Business Name): JOST PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2005
Last Update Date: 02/02/2023
Certification Date: 02/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3601 QUENTIN RD
BROOKLYN NY
11234-4203
US

IV. Provider business mailing address

3601 QUENTIN RD
BROOKLYN NY
11234-4203
US

V. Phone/Fax

Practice location:
  • Phone: 718-339-3110
  • Fax: 718-339-5260
Mailing address:
  • Phone: 718-339-3110
  • Fax: 718-339-5260

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number020118
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MR. RADA LEVKOVSKAYA
Title or Position: VICE PRESIDENT
Credential:
Phone: 718-339-3110