Provider Demographics
NPI:1710410022
Name:JANE'S PHARMACY, LLC
Entity Type:Organization
Organization Name:JANE'S PHARMACY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NAVAS
Authorized Official - Middle Name:
Authorized Official - Last Name:YOONUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-525-3142
Mailing Address - Street 1:950 MAIN ST
Mailing Address - Street 2:SUITE 100, PO BOX 215
Mailing Address - City:MUNFORDVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42765-9435
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:950 MAIN ST
Practice Address - Street 2:SUITE 100
Practice Address - City:MUNFORDVILLE
Practice Address - State:KY
Practice Address - Zip Code:42765-9435
Practice Address - Country:US
Practice Address - Phone:615-525-3142
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-04
Last Update Date:2017-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy