MEDICARE: JMC PHARMACY INC

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	3336C0004X	Compounding Pharmacy
2	333600000X	Pharmacy
3	3336C0003X	Community/Retail Pharmacy	015799	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2060092	OTHER		PK

General Provider Information

NPI Number	:	1477598563
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JMC PHARMACY INC

Provider Business Mailing Address
First Line	:	9315 ROOSEVELT AVE
Second Line	:
City	:	JACKSON HEIGHTS
State	:	NY
Zip	:	11372-7943
Country	:	US
Telephone Number	:	718-478-7968
Fax Number	:	718-478-7969

Provider Business Practice Location Address
First Line	:	3875 BROADWAY UNIT A
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10032-1567
Country	:	US
Telephone Number	:	212-795-4909
Fax Number	:	212-795-2043

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JOSE CAMPON
Credential	:
Telephone Number	:	212-795-7909

Provider Enumeration Date	:	06/20/2006
Last Update Date	:	11/05/2025

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Directions to “JMC PHARMACY INC ” Practice Location

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