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General NPI Number Information
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NPI Number | 1336235902
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Entity Type | Organization
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Legal Business Name | JAYHAWK HOLDINGS INC
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Dates
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Enumeration Date | 10/04/2006
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Last Update Date | 11/30/2010
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Provider Practice Location Address
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Address Line | 2626 FEDERAL ST
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City | CAMDEN
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State | NJ
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Zip | 08105-1936
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Country | US
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Telephone | 856-963-0300
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Fax | 856-963-2202
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Provider Business Mailing Address
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Address Line | 2626 FEDERAL ST
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City | CAMDEN
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State | NJ
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Zip | 08105-1936
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Country | US
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Telephone | 856-963-0300
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Fax | 856-963-2202
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Authorized Official
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Title or Position | CONTRACT MANAGER
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Name | DEBORAH R KEAVENY
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Credential | RPH
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Telephone | 612-227-7811
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 28RS00693000
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License Number State | NJ
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