Provider Demographics
NPI:1770842023
Name:DEVDARSHAN INC
Entity Type:Organization
Organization Name:DEVDARSHAN INC
Other - Org Name:JOGI DISCOUNT PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAKESH
Authorized Official - Middle Name:
Authorized Official - Last Name:KUNDALIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-703-0375
Mailing Address - Street 1:1502 ATLANTIC AVE
Mailing Address - Street 2:
Mailing Address - City:ATLANTIC CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:08401-7011
Mailing Address - Country:US
Mailing Address - Phone:609-957-6499
Mailing Address - Fax:609-541-2052
Practice Address - Street 1:1502 ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:ATLANTIC CITY
Practice Address - State:NJ
Practice Address - Zip Code:08401-7011
Practice Address - Country:US
Practice Address - Phone:609-957-6499
Practice Address - Fax:609-541-2052
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-07
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NJ28RS007200003336C0003X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2136001OtherPK
NJ0336343Medicaid