Provider Demographics
NPI:1952758781
Name:JANEO LLC
Entity Type:Organization
Organization Name:JANEO LLC
Other - Org Name:ELEMENTS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO/AO/PIC
Authorized Official - Prefix:
Authorized Official - First Name:SHERRI
Authorized Official - Middle Name:
Authorized Official - Last Name:CHERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:818-726-2055
Mailing Address - Street 1:10153 1/2 RIVERSIDE DR # 456
Mailing Address - Street 2:ATTN: SHERRI CHERMAN, PHARMD
Mailing Address - City:TOLUCA LAKE
Mailing Address - State:CA
Mailing Address - Zip Code:91602-2561
Mailing Address - Country:US
Mailing Address - Phone:818-762-2055
Mailing Address - Fax:818-330-4550
Practice Address - Street 1:12602-12604 VENTURA BLVD.
Practice Address - Street 2:
Practice Address - City:STUDIO CITY
Practice Address - State:CA
Practice Address - Zip Code:91604-2414
Practice Address - Country:US
Practice Address - Phone:818-762-2055
Practice Address - Fax:818-330-4550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-23
Last Update Date:2020-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
291U00000X, 333600000X
CA543333336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No291U00000XLaboratoriesClinical Medical Laboratory
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2160292OtherPK
7557710001Medicare NSC