Provider Demographics
NPI:1669586558
Name:J AND J PHARMACY INC
Entity type:Organization
Organization Name:J AND J PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMIN MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:L
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-828-0110
Mailing Address - Street 1:7250 W 24TH AVE
Mailing Address - Street 2:SUITE 10
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-6575
Mailing Address - Country:US
Mailing Address - Phone:305-828-0110
Mailing Address - Fax:305-828-8990
Practice Address - Street 1:7250 W 24TH AVE
Practice Address - Street 2:SUITE 10
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-6575
Practice Address - Country:US
Practice Address - Phone:305-828-0110
Practice Address - Fax:305-828-8990
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-18
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH218513336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPH 21851OtherPHARMACY LICENSE
1019202OtherOTHER ID NUMBER-COMMERCIAL NUMBER
FLPH 21851OtherPHARMACY LICENSE