MEDICARE: JHA PHARMA LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	333600000X	Pharmacy
2	3336C0003X	Community/Retail Pharmacy

General Provider Information

NPI Number	:	1013401058
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JHA PHARMA LLC

Provider Business Mailing Address
First Line	:	123 LAIDLAW AVE
Second Line	:
City	:	JERSEY CITY
State	:	NJ
Zip	:	07306-2512
Country	:	US
Telephone Number	:	201-780-7210
Fax Number	:

Provider Business Practice Location Address
First Line	:	3350 FULTON ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11208-2034
Country	:	US
Telephone Number	:	718-277-5371
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	RATHNA VEERAMACHANANI
Credential	:
Telephone Number	:	201-780-7210

Provider Enumeration Date	:	06/21/2018
Last Update Date	:	02/07/2024

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