Provider Demographics
NPI:1932957529
Name:JASMINE ORGANIC RX INC
Entity Type:Organization
Organization Name:JASMINE ORGANIC RX INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MIKHAIL
Authorized Official - Middle Name:
Authorized Official - Last Name:BORUKHOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-649-1422
Mailing Address - Street 1:9722 66TH AVE
Mailing Address - Street 2:
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-4246
Mailing Address - Country:US
Mailing Address - Phone:347-649-1422
Mailing Address - Fax:888-778-5011
Practice Address - Street 1:9722 66TH AVE
Practice Address - Street 2:
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-4246
Practice Address - Country:US
Practice Address - Phone:347-649-1422
Practice Address - Fax:888-778-5011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-08
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy