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General NPI Number Information
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NPI Number | 1912957127
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Entity Type | Organization
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Legal Business Name | JR PHARMACY PLLC
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Dates
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Enumeration Date | 05/10/2006
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Last Update Date | 12/02/2008
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Provider Practice Location Address
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Address Line | 2160 WHISPER LAKES BLVD
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City | ORLANDO
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State | FL
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Zip | 32837-6762
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Country | US
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Telephone | 407-447-5612
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Fax | 407-447-5614
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Provider Business Mailing Address
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Address Line | 2160 WHISPER LAKES BLVD
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City | ORLANDO
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State | FL
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Zip | 32837-6762
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGING MBR
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Name | ROJER TEWARI
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Credential | RPH
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Telephone | 407-967-8237
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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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 | PH21994
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License Number State | FL
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