Ja Cobex, LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PP482144 Issued in PA

Legal business name

JA COBEX, LLC

Doing business as

Philly Pharmacy

Practice address

1900 Grant Ave Ste F
Philadelphia, PA 19115-4370

Phone

(215) 969-5180

Fax

(866) 379-3198

NPI assigned

Feb 1, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Tam Oniate

Title

Manager

Phone

(215) 969-5180

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Philly Pharmacy Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1359676800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492560000000",
    "number": "1336488998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 GRANT AVE STE F",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191154370",
            "telephone_number": "215-969-5180",
            "fax_number": "866-379-3198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 GRANT AVE STE F",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191154370",
            "telephone_number": "215-969-5180",
            "fax_number": "866-379-3198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JA COBEX, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-01",
        "last_updated": "2017-04-19",
        "status": "A",
        "authorized_official_last_name": "ONIATE",
        "authorized_official_first_name": "TAM",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "215-969-5180"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "PA",
            "license": "PP482144",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1028047850002",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2138971",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Philly Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.