Provider Demographics
NPI:1770137267
Name:JEN PHARMA INC
Entity type:Organization
Organization Name:JEN PHARMA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SMITHA
Authorized Official - Middle Name:
Authorized Official - Last Name:DASARI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-577-6989
Mailing Address - Street 1:205 SUMMER AVE
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07104-2628
Mailing Address - Country:US
Mailing Address - Phone:973-481-3388
Mailing Address - Fax:973-481-0625
Practice Address - Street 1:205 SUMMER AVE
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07104-2628
Practice Address - Country:US
Practice Address - Phone:973-481-3388
Practice Address - Fax:973-481-0625
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-01
Last Update Date:2019-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy