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General NPI Number Information
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NPI Number | 1194144485
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Entity Type | Organization
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Legal Business Name | KNIGHTS JXL PHARMACY INC
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Dates
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Enumeration Date | 04/15/2014
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Last Update Date | 04/16/2025
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Provider Practice Location Address
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Address Line | 18120 BROOKHURST ST STE 57
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City | FOUNTAIN VALLEY
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State | CA
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Zip | 92708-6727
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Country | US
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Telephone | 714-962-7192
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Fax | 714-962-1741
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Provider Business Mailing Address
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Address Line | 18120 BROOKHURST ST STE 57
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City | FOUNTAIN VALLEY
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State | CA
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Zip | 92708-6727
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Country | US
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Telephone | 714-962-7192
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Fax | 714-962-1741
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | JIAJUN XUE
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Credential |
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Telephone | 714-962-7192
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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