Provider Demographics
NPI:1104325174
Name:JINAL PHARMACY LLC
Entity type:Organization
Organization Name:JINAL PHARMACY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MUJTABA
Authorized Official - Middle Name:J
Authorized Official - Last Name:BHATTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-865-4364
Mailing Address - Street 1:1861 PRINCETON AVE
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08648-4517
Mailing Address - Country:US
Mailing Address - Phone:786-299-4734
Mailing Address - Fax:609-571-3151
Practice Address - Street 1:121 MAIN AVE
Practice Address - Street 2:
Practice Address - City:PASSAIC
Practice Address - State:NJ
Practice Address - Zip Code:07055-0001
Practice Address - Country:US
Practice Address - Phone:973-777-8048
Practice Address - Fax:973-779-2909
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-06
Last Update Date:2018-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy