Organization
JOLORE SERVICES CORPORATION
Active
Other names
OMNI PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JOEL GOLDSTEIN (PRESIDENT)
(631) 957-8630
Entity
Organization
Contact information
Practice address
150 E SUNRISE HWY, SUITE 100, LINDENHURST, NY 11757
(631) 957-8630
Mailing address
150 E SUNRISE HWY, SUITE 100, LINDENHURST, NY 11757
(631) 957-8630
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
024154
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02278095
—
NY
01
—
2060922
PK
—
Enumeration date
03/05/2007
Last updated
01/17/2017
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