Provider Demographics
NPI:1417472697
Name:JP PHARMACY INC.
Entity Type:Organization
Organization Name:JP PHARMACY INC.
Other - Org Name:JP PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SUBODHCHANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:MASALAWALA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-203-8444
Mailing Address - Street 1:27301 SCHOENHERR RD STE 106
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48088-6649
Mailing Address - Country:US
Mailing Address - Phone:586-203-8444
Mailing Address - Fax:586-486-3433
Practice Address - Street 1:27301 SCHOENHERR RD STE 106
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48088-6649
Practice Address - Country:US
Practice Address - Phone:586-203-8444
Practice Address - Fax:586-486-3433
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-08
Last Update Date:2020-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI53010112253336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy