Provider Demographics
NPI:1265492185
Name:JBDL CORPORATION
Entity type:Organization
Organization Name:JBDL CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHCY MGR
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:CARAMANICO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-586-3100
Mailing Address - Street 1:1004 CHESTER PIKE
Mailing Address - Street 2:
Mailing Address - City:SHARON HILL
Mailing Address - State:PA
Mailing Address - Zip Code:19079-1913
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1004 CHESTER PIKE
Practice Address - Street 2:
Practice Address - City:SHARON HILL
Practice Address - State:PA
Practice Address - Zip Code:19079-1913
Practice Address - Country:US
Practice Address - Phone:610-586-3100
Practice Address - Fax:610-586-3700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336H0001X, 3336C0003X, 3336L0003X
PAPP410137L333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
Not Answered3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Not Answered333600000XSuppliersPharmacy
Not Answered3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
3903398OtherOTHER ID NUMBER-COMMERCIAL NUMBER
PA000577774001Medicaid
3903398OtherOTHER ID NUMBER-COMMERCIAL NUMBER