Provider Demographics
NPI:1386828259
Name:C.J.S. PHARMACY, INC.
Entity Type:Organization
Organization Name:C.J.S. PHARMACY, INC.
Other - Org Name:MERRICK SURGICAL SUPPLY AND HOMECARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LEO
Authorized Official - Middle Name:
Authorized Official - Last Name:LEVINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-378-0119
Mailing Address - Street 1:131 MERRICK AVE
Mailing Address - Street 2:
Mailing Address - City:MERRICK
Mailing Address - State:NY
Mailing Address - Zip Code:11566-3147
Mailing Address - Country:US
Mailing Address - Phone:516-378-0119
Mailing Address - Fax:516-378-5210
Practice Address - Street 1:131 MERRICK AVENUE
Practice Address - Street 2:
Practice Address - City:MERRICK
Practice Address - State:NY
Practice Address - Zip Code:11566-3147
Practice Address - Country:US
Practice Address - Phone:516-378-0119
Practice Address - Fax:516-378-5210
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:C.J.S. PHARMACY, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-12-27
Last Update Date:2010-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00378092Medicaid
NY00378092Medicaid