Provider Demographics
NPI:1558427435
Name:JANOS PHARMACY ENTERPRISE INC
Entity Type:Organization
Organization Name:JANOS PHARMACY ENTERPRISE INC
Other - Org Name:GRECO APOTHECARY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JANO
Authorized Official - Middle Name:
Authorized Official - Last Name:JAMES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-636-1400
Mailing Address - Street 1:704 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FREELAND
Mailing Address - State:PA
Mailing Address - Zip Code:18224-1915
Mailing Address - Country:US
Mailing Address - Phone:570-636-1400
Mailing Address - Fax:570-636-0508
Practice Address - Street 1:704 MAIN ST
Practice Address - Street 2:
Practice Address - City:FREELAND
Practice Address - State:PA
Practice Address - Zip Code:18224-1915
Practice Address - Country:US
Practice Address - Phone:570-636-1400
Practice Address - Fax:570-636-0508
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-28
Last Update Date:2012-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
PAPP412792L3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
3943722OtherNCPDP PROVIDER IDENTIFICATION NUMBER
PA102603286Medicaid
PA102603286Medicaid