Provider Demographics
NPI:1598256760
Name:JASH HEALTHCARE LLC
Entity Type:Organization
Organization Name:JASH HEALTHCARE LLC
Other - Org Name:EXPRESS PHARMACY#3
Other - Org Type:Other Name
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:SACHIN
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-216-5500
Mailing Address - Street 1:1445 SW MILITARY DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78221-1539
Mailing Address - Country:US
Mailing Address - Phone:210-333-3700
Mailing Address - Fax:210-333-3707
Practice Address - Street 1:1445 SW MILITARY DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78221-1539
Practice Address - Country:US
Practice Address - Phone:210-333-3700
Practice Address - Fax:210-333-3707
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-23
Last Update Date:2018-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
TX320763336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2177848OtherPK