Provider Demographics
NPI:1528898384
Name:AVE J ROYAL CARE PHARMACY LLC
Entity type:Organization
Organization Name:AVE J ROYAL CARE PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARJAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHIFTEH
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:718-253-1030
Mailing Address - Street 1:1315 AVENUE J
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-3605
Mailing Address - Country:US
Mailing Address - Phone:718-253-1030
Mailing Address - Fax:718-676-2665
Practice Address - Street 1:1315 AVENUE J
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-3605
Practice Address - Country:US
Practice Address - Phone:718-253-1030
Practice Address - Fax:718-676-2665
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AVE J ROYAL CARE PHARMACY LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-08-06
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy