Organization
JEFFERSON PHARMA LLC
Active
Other names
FEEL GOOD PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
RAVINDER RAO ANNAMANENI (MEMBER)
(929) 777-9108
Entity
Organization
Contact information
Practice address
3058 3RD AVE, BRONX, NY 10451-4605
(929) 777-9108
(929) 777-9109
Mailing address
3058 3RD AVE, BRONX, NY 10451-4605
(929) 777-9108
(929) 777-9109
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
031367
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03456062
—
NY
01
—
2136214
PK
—
Enumeration date
04/18/2012
Last updated
02/02/2022
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