Provider Demographics
NPI:1316567977
Name:JANT PHARMACY LLC
Entity Type:Organization
Organization Name:JANT PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KOFI
Authorized Official - Middle Name:
Authorized Official - Last Name:JANTUAH
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:301-523-7087
Mailing Address - Street 1:8771 PINEY ORCHARD PKWY
Mailing Address - Street 2:
Mailing Address - City:ODENTON
Mailing Address - State:MD
Mailing Address - Zip Code:21113-2245
Mailing Address - Country:US
Mailing Address - Phone:301-523-7087
Mailing Address - Fax:
Practice Address - Street 1:8771 PINEY ORCHARD PKWY
Practice Address - Street 2:
Practice Address - City:ODENTON
Practice Address - State:MD
Practice Address - Zip Code:21113-2245
Practice Address - Country:US
Practice Address - Phone:301-523-7087
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-23
Last Update Date:2021-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes333600000XSuppliersPharmacyGroup - Single Specialty