Provider Demographics
NPI:1376678359
Name:JJJA INC
Entity Type:Organization
Organization Name:JJJA INC
Other - Org Name:RUBIO PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEAN-PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:ABCAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-990-5100
Mailing Address - Street 1:PO BOX 260944
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91426-0944
Mailing Address - Country:US
Mailing Address - Phone:818-990-5100
Mailing Address - Fax:818-990-4613
Practice Address - Street 1:16550 VENTURA BLVD STE 100
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-2010
Practice Address - Country:US
Practice Address - Phone:818-990-5100
Practice Address - Fax:818-990-4613
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336C0003X
CAPHY47149332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3336C0003XSuppliersPharmacyCommunity/Retail PharmacyGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPHA405930Medicaid
CAPHA405930Medicaid