Provider Demographics
NPI:1811525264
Name:AJW PHARMACY LLC
Entity type:Organization
Organization Name:AJW PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JANELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHRISTOPHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-631-8291
Mailing Address - Street 1:354 HEMPSTEAD AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:WEST HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11552-2053
Mailing Address - Country:US
Mailing Address - Phone:516-416-4430
Mailing Address - Fax:
Practice Address - Street 1:354 HEMPSTEAD AVE APT 1
Practice Address - Street 2:
Practice Address - City:WEST HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11552-2053
Practice Address - Country:US
Practice Address - Phone:516-416-4430
Practice Address - Fax:516-416-4432
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-31
Last Update Date:2020-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy