Provider Demographics
NPI:1154665768
Name:J AND D PHARMACY
Entity Type:Organization
Organization Name:J AND D PHARMACY
Other - Org Name:SYWELL PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAVI
Authorized Official - Middle Name:
Authorized Official - Last Name:MORRISETTY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-641-1193
Mailing Address - Street 1:12895 JOSEY LN.
Mailing Address - Street 2:#111
Mailing Address - City:FARMERS BRANCH
Mailing Address - State:TX
Mailing Address - Zip Code:75234
Mailing Address - Country:US
Mailing Address - Phone:646-641-1193
Mailing Address - Fax:817-413-0570
Practice Address - Street 1:12895 JOSEY LN.
Practice Address - Street 2:#111
Practice Address - City:FARMERS BRANCH
Practice Address - State:TX
Practice Address - Zip Code:75234
Practice Address - Country:US
Practice Address - Phone:646-641-1193
Practice Address - Fax:817-413-0570
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-20
Last Update Date:2015-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatricGroup - Single Specialty