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General NPI Number Information
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NPI Number | 1679677132
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Entity Type | Organization
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Legal Business Name | JOLIN RX INC.
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Dates
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Enumeration Date | 09/12/2006
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Last Update Date | 10/02/2020
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Provider Practice Location Address
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Address Line | 1870 GRAND CONCOURSE
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City | BRONX
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State | NY
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Zip | 10457-5401
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Country | US
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Telephone | 718-294-5588
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Fax | 718-716-3041
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Provider Business Mailing Address
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Address Line | 1870 GRANDCONCOURSE
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City | BRONX
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State | NY
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Zip | 10457-5401
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Country | US
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Telephone | 718-294-5588
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Fax | 718-294-5589
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Authorized Official
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Title or Position | SUPERVISING PHARMACIST / MANAGER
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Name | MR. RAJESH MATHEW
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Credential | R.PH.
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Telephone | 718-294-5588
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 15244
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License Number State | NY
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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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