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General NPI Number Information
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NPI Number | 1730833310
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Entity Type | Organization
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Legal Business Name | JSA HEALTHCARE SERVICES LLC
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Dates
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Enumeration Date | 02/11/2022
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Last Update Date | 03/15/2022
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Provider Practice Location Address
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Address Line | 19239 STONE OAK PKWY STE 103
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City | SAN ANTONIO
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State | TX
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Zip | 78258-3471
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Country | US
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Telephone | 210-314-6464
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Fax | 210-314-6465
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Provider Business Mailing Address
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Address Line | 3035 FALL CREST DR
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City | SAN ANTONIO
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State | TX
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Zip | 78247-3235
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Country | US
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Telephone | 561-305-3648
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Fax | 210-314-6465
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Authorized Official
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Title or Position | MANAGER
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Name | LUBNA ALGHOUL
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Credential |
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Telephone | 561-305-3648
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number |
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License Number State |
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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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Taxonomy #3
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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