Healthcare Provider Details

I. General information

NPI: 1326131632
Provider Name (Legal Business Name): JMK PHARMACY CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 07/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4721 13TH AVE
BROOKLYN NY
11219-2602
US

IV. Provider business mailing address

4721 13TH AVE
BROOKLYN NY
11219-2602
US

V. Phone/Fax

Practice location:
  • Phone: 718-438-6555
  • Fax: 718-438-7353
Mailing address:
  • Phone: 718-438-6555
  • Fax: 718-438-7353

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 Number025110
License Number StateNY

VIII. Authorized Official

Name: MARCO ALKADA
Title or Position: CO OWNER
Credential: RPH
Phone: 718-438-6555