Provider Demographics
NPI:1518216555
Name:JKS HEALTHCARE INC
Entity Type:Organization
Organization Name:JKS HEALTHCARE INC
Other - Org Name:VERONICA PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER, PIC, AO
Authorized Official - Prefix:
Authorized Official - First Name:JASWINDER
Authorized Official - Middle Name:
Authorized Official - Last Name:SEHGAL
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:732-227-4994
Mailing Address - Street 1:84 VERONICA AVE
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873-3529
Mailing Address - Country:US
Mailing Address - Phone:732-227-4994
Mailing Address - Fax:732-227-4997
Practice Address - Street 1:84 VERONICA AVE
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873-3529
Practice Address - Country:US
Practice Address - Phone:732-227-4994
Practice Address - Fax:732-227-4997
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-06
Last Update Date:2016-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0004X
NJ28RS007210003336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0355640Medicaid
2136691OtherPK