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General NPI Number Information
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NPI Number | 1629604368
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Entity Type | Organization
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Legal Business Name | JAFA PHARMACEUTICALS, INC.
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Dates
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Enumeration Date | 03/13/2020
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Last Update Date | 03/13/2020
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Provider Practice Location Address
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Address Line | 95 MONTGOMERY DR STE 108
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City | SANTA ROSA
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State | CA
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Zip | 95404-6617
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Country | US
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Telephone | 707-525-1130
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Fax | 707-525-8099
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Provider Business Mailing Address
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Address Line | 95 MONTGOMERY DR STE 108
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City | SANTA ROSA
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State | CA
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Zip | 95404-6617
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Country | US
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Telephone | 707-525-1130
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Fax | 707-525-8099
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Authorized Official
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Title or Position | CEO
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Name | TONY IBRAHIM
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Credential |
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Telephone | 760-987-6796
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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