Provider Demographics
NPI:1518011097
Name:J&D HEALTHSYSTEMS, INC.
Entity Type:Organization
Organization Name:J&D HEALTHSYSTEMS, INC.
Other - Org Name:JDX PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CHHITU
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:805-922-1747
Mailing Address - Street 1:1504 S BROADWAY
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93454-7214
Mailing Address - Country:US
Mailing Address - Phone:805-922-1747
Mailing Address - Fax:805-925-6499
Practice Address - Street 1:1504 S BROADWAY
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93454-7214
Practice Address - Country:US
Practice Address - Phone:805-922-1747
Practice Address - Fax:805-925-6499
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-22
Last Update Date:2020-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY43315332B00000X, 3336L0003X
CAPHY41335333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPHA433150Medicaid
CAPHA433150Medicaid