Organization
JETKAT, INC.
Active
Other names
DBA The Pharmacy Shop
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KIM ANTHONY TENREIRO RPH. (SECRETARY JETKAT INC.)
(585) 396-9970
Entity
Organization
Contact information
Practice address
66 WEST AVE, CANANDAIGUA, NY 14424
(585) 396-9970
(585) 396-7264
Mailing address
66 WEST AVE, CANANDAIGUA, NY 14424
(585) 396-9970
(585) 396-7264
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
022695
NY
3336C0003X
Community/Retail Pharmacy
—
NY
3336C0004X
Compounding Pharmacy
Primary
22695
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01593140
—
NY
01
—
3395971
NCPDP #
NY
Enumeration date
01/16/2007
Last updated
03/07/2023
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