# SAN JOSE PHARMACY INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164167896
- **Authorized official:** MR. KENNETH GONZALEZ (CO/OWNER)
- **Authorized official phone:** (347) 642-4904

## Contact information

- **Practice address:** 8424 37TH AVE, JACKSON HEIGHTS, NY 11372-7339
- **Practice address phone:** (347) 642-4904
- **Practice address fax:** (347) 531-0739
- **Mailing address:** 8424 37TH AVE, JACKSON HEIGHTS, NY 11372-7339
- **Mailing address phone:** (347) 642-4904

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 04/27/2022
- **Last updated:** 04/27/2022