Provider Demographics
NPI:1164660437
Name:JANNA PHARMACY, LLC
Entity Type:Organization
Organization Name:JANNA PHARMACY, LLC
Other - Org Name:APOTHECO PHARMACY CHOICE TORRANCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:GENERAL COUNSEL
Authorized Official - Prefix:
Authorized Official - First Name:NIKKI
Authorized Official - Middle Name:
Authorized Official - Last Name:BANIEWICZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-869-2820
Mailing Address - Street 1:788 MORRIS TURNPIKE
Mailing Address - Street 2:FL 3
Mailing Address - City:SHORT HILLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07078
Mailing Address - Country:US
Mailing Address - Phone:973-869-2820
Mailing Address - Fax:973-869-2822
Practice Address - Street 1:4201 TORRANCE BLVD
Practice Address - Street 2:SUITE 120
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-4579
Practice Address - Country:US
Practice Address - Phone:310-543-1111
Practice Address - Fax:310-543-1114
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-26
Last Update Date:2023-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA516113336C0003X
3336C0003X, 3336C0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2142369OtherPK