Organization
JJS PHARMACY LLC
Active
Other names
JJS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN LEE RPH (OWNER)
(909) 595-4003
Entity
Organization
Contact information
Practice address
21010 GOLDEN SPRINGS DR, DIAMOND BAR, CA 91789-3831
(909) 595-4003
(909) 598-2161
Mailing address
21010 GOLDEN SPRINGS DR, DIAMOND BAR, CA 91789-3831
(909) 595-4003
(909) 595-1354
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
47312
CA
3336M0003X
Managed Care Organization Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2113793
PK
—
05
—
PHA473120
—
CA
Enumeration date
10/10/2006
Last updated
09/05/2013
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