Provider Demographics
NPI:1124166624
Name:JO-MAR INC.
Entity type:Organization
Organization Name:JO-MAR INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT JO-MAR INC
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:J
Authorized Official - Last Name:MARCHELEWICZ
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:802-479-2521
Mailing Address - Street 1:921 US RT 302
Mailing Address - Street 2:
Mailing Address - City:BARRE
Mailing Address - State:VT
Mailing Address - Zip Code:05641-4465
Mailing Address - Country:US
Mailing Address - Phone:802-479-2521
Mailing Address - Fax:802-476-2091
Practice Address - Street 1:921 US RT 302
Practice Address - Street 2:
Practice Address - City:BARRE
Practice Address - State:VT
Practice Address - Zip Code:05641-4465
Practice Address - Country:US
Practice Address - Phone:802-479-2521
Practice Address - Fax:802-476-2091
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-05
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0380001252333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
4701252OtherNCPDP
VT0007273Medicaid