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General NPI Number Information
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NPI Number | 1548528623
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Entity Type | Organization
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Legal Business Name | JNCN HOLDINGS LLC
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Dates
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Enumeration Date | 04/26/2012
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Last Update Date | 06/12/2012
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Provider Practice Location Address
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Address Line | 16842 HIGHWAY 3
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City | WEBSTER
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State | TX
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Zip | 77598-2112
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Country | US
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Telephone | 832-932-5747
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Fax | 832-932-5749
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Provider Business Mailing Address
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Address Line | 2751 VELA
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City | GRAND PRAIRIE
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State | TX
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Zip | 75054-5538
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Country | US
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Telephone | 682-422-3258
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Fax | 682-422-3004
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Authorized Official
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Title or Position | OWNER
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Name | CONNEKA NEAL
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Credential |
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Telephone | 682-422-3258
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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 | 26903
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License Number State | TX
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