Healthcare Provider Details

I. General information

NPI: 1871579680
Provider Name (Legal Business Name): JAYSON DRUGS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/22/2005
Last Update Date: 02/27/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

197 FRANKLIN AVE
FRANKLIN SQUARE NY
11010-1435
US

IV. Provider business mailing address

197 FRANKLIN AVE
FRANKLIN SQUARE NY
11010-1435
US

V. Phone/Fax

Practice location:
  • Phone: 516-354-5641
  • Fax: 516-354-3790
Mailing address:
  • Phone: 516-354-5641
  • Fax: 516-354-3790

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number027392
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MR. JAMES B EHRLEIN JR.
Title or Position: PRESIDENT
Credential: BSPHARM, PHARMD
Phone: 516-354-5641