Organization
JR PHARMACY PLLC
Active
Other names
JR PHARMACY PLLC
Organization subpart
No
Provider details
NPI number
Authorized official
ROJER TEWARI RPH (MANAGING MBR)
(407) 967-8237
Entity
Organization
Contact information
Practice address
2160 WHISPER LAKES BLVD, ORLANDO, FL 32837-6762
(407) 447-5612
(407) 447-5614
Mailing address
2160 WHISPER LAKES BLVD, ORLANDO, FL 32837-6762
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH21994
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
031430700
—
FL
05
—
031430701
—
FL
01
—
1018969
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
05/10/2006
Last updated
12/02/2008
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