Provider Demographics
NPI:1124133152
Name:JEN MAR PHARMACY SERVICES INC
Entity type:Organization
Organization Name:JEN MAR PHARMACY SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:GUZMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-936-9598
Mailing Address - Street 1:7901 N ARMENIA AVE
Mailing Address - Street 2:STE D
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33604-3847
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7901 N ARMENIA AVE
Practice Address - Street 2:STE D
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33604-3847
Practice Address - Country:US
Practice Address - Phone:813-936-9598
Practice Address - Fax:813-936-9599
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH0017909333600000X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered333600000XSuppliersPharmacy
Not Answered3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1093373OtherOTHER ID NUMBER-COMMERCIAL NUMBER