Provider Demographics
NPI:1962842039
Name:JAYRON PHARMACY CORP
Entity Type:Organization
Organization Name:JAYRON PHARMACY CORP
Other - Org Name:TREMONT DRUGS
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JIGNESH
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-936-7296
Mailing Address - Street 1:489 E TREMONT AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10457-4401
Mailing Address - Country:US
Mailing Address - Phone:917-801-1000
Mailing Address - Fax:917-801-1001
Practice Address - Street 1:489 E TREMONT AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457-4401
Practice Address - Country:US
Practice Address - Phone:917-801-1000
Practice Address - Fax:917-801-1001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-03
Last Update Date:2017-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY17-032136302R00000X
NY035616333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No302R00000XManaged Care OrganizationsHealth Maintenance Organization