Provider Demographics
NPI:1972813723
Name:JANALL LLC
Entity Type:Organization
Organization Name:JANALL LLC
Other - Org Name:HAYAT PHARMACY 1
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:HASHIM
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAIBAK
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:414-712-5200
Mailing Address - Street 1:PO BOX 13337
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53213-0337
Mailing Address - Country:US
Mailing Address - Phone:414-931-0000
Mailing Address - Fax:441-931-0001
Practice Address - Street 1:3727 W WISCONSIN AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53208-3182
Practice Address - Country:US
Practice Address - Phone:414-931-0000
Practice Address - Fax:414-931-0001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-14
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
WI9037-0423336C0003X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2127204OtherPK