Provider Demographics
NPI:1386016525
Name:JETHAKAUSHKAMAL INC
Entity Type:Organization
Organization Name:JETHAKAUSHKAMAL INC
Other - Org Name:CARE PLUS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:SONA
Authorized Official - Middle Name:
Authorized Official - Last Name:VASWANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-258-0663
Mailing Address - Street 1:982 STUYVESANT AVE UNIT D
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-6906
Mailing Address - Country:US
Mailing Address - Phone:908-258-0663
Mailing Address - Fax:866-264-5084
Practice Address - Street 1:982 STUYVESANT AVE UNIT D
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083-6906
Practice Address - Country:US
Practice Address - Phone:908-258-0663
Practice Address - Fax:866-264-5084
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-28
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RS007453003336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2171996OtherPK