Provider Demographics
NPI:1992871008
Name:JENNIFER-JOHN PHARMACY INC
Entity type:Organization
Organization Name:JENNIFER-JOHN PHARMACY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:
Authorized Official - Last Name:GRIFFITHS
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:914-234-3744
Mailing Address - Street 1:424 OLD POST RD
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:NY
Mailing Address - Zip Code:10506-1018
Mailing Address - Country:US
Mailing Address - Phone:914-234-3744
Mailing Address - Fax:914-234-0652
Practice Address - Street 1:424 OLD POST RD
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:NY
Practice Address - Zip Code:10506-1018
Practice Address - Country:US
Practice Address - Phone:914-234-3744
Practice Address - Fax:914-234-0652
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
Last Update Date:2010-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NY0168153336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
3354216OtherNCPDP PROVIDER IDENTIFICATION NUMBER