Healthcare Provider Details

I. General information

NPI: 1033203682
Provider Name (Legal Business Name): JPM HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 08/19/2020
Certification Date: 08/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3436 34TH ST
LUBBOCK TX
79410-2830
US

IV. Provider business mailing address

10113 CHICAGO AVE
LUBBOCK TX
79424-8254
US

V. Phone/Fax

Practice location:
  • Phone: 806-799-3636
  • Fax: 806-795-4622
Mailing address:
  • Phone: 806-789-9806
  • Fax: 855-710-8041

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number27815
License Number StateTX

VIII. Authorized Official

Name: DR. JIGNA PATEL
Title or Position: OWNER/PRESIDENT
Credential: PHARMD
Phone: 806-789-9806