Provider Demographics
NPI:1982903258
Name:CAJERAS, JOSE POLLY BOJOS (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:JOSE POLLY
Middle Name:BOJOS
Last Name:CAJERAS
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:567 S LOWRY ST
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:TN
Mailing Address - Zip Code:37167-3803
Mailing Address - Country:US
Mailing Address - Phone:615-459-7722
Mailing Address - Fax:615-459-3831
Practice Address - Street 1:567 S LOWRY ST
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:TN
Practice Address - Zip Code:37167-3803
Practice Address - Country:US
Practice Address - Phone:615-459-7722
Practice Address - Fax:615-459-3831
Is Sole Proprietor?:No
Enumeration Date:2011-03-25
Last Update Date:2011-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN33360183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist