Organization
SJS PHARMACY INC
Active
Other names
SJS PHARMACY INC
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD ILYAICH (OWNER)
(718) 933-1222
Entity
Organization
Contact information
Practice address
105-107 E BURNSIDE AVE, BRONX, NY 10453-4142
(718) 933-1222
(718) 933-1255
Mailing address
105-107 E BURNSIDE AVE, BRONX, NY 10453-4142
(718) 933-1222
(718) 933-1255
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
014956
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00264659
—
NY
01
—
3349897
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
09/30/2006
Last updated
10/12/2021
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