Organization
222 JAMAICA DRUG LLC
Active
Other names
Boca Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JACOB JAMRON (CEO)
(718) 971-9391
Entity
Organization
Contact information
Practice address
221 21 JAMAICA AVE, QUEENS VILLAGE, NY 11428-2097
(718) 465-5196
(718) 468-7782
Mailing address
PO BOX 740054, BRONX, NY 10474-0001
(718) 971-9391
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
034857
NY
3336C0003X
Community/Retail Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2163791
PK
—
Enumeration date
08/23/2016
Last updated
09/13/2016
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