=====================================================
General NPI Number Information
=====================================================
NPI Number | 1609828243
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | J&A DRUGS INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/16/2006
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 954 NOSTRAND AVE
-----------------------------------------------------
City | BROOKLYN
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11225-3001
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 718-467-1111
-----------------------------------------------------
Fax | 718-467-4140
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 954 NOSTRAND AVE
-----------------------------------------------------
City | BROOKLYN
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11225-3001
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 718-467-1111
-----------------------------------------------------
Fax | 718-467-4140
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | VICE PRESIDENT
-----------------------------------------------------
Name | PERVAIZ A SHAIKH
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 718-467-1111
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 011452
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------