Healthcare Provider Details

I. General information

NPI: 1235289471
Provider Name (Legal Business Name): JADD PHARMACY CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2007
Last Update Date: 09/06/2022
Certification Date: 09/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

253 ROCK HILL DRIVE
ROCK HILL NY
12775
US

IV. Provider business mailing address

PO BOX 777
ROCK HILL NY
12775-0777
US

V. Phone/Fax

Practice location:
  • Phone: 845-791-1515
  • Fax: 845-791-1045
Mailing address:
  • Phone: 845-791-1515
  • Fax: 845-791-1045

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DR. JOSEPH W GIANGIACOMO
Title or Position: OWNER
Credential: PHARMD
Phone: 845-791-1515