Jra Drug Corp

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

028965 Issued in NY

Legal business name

JRA DRUG CORP

Practice address

506 W 207TH St
New York, NY 10034-2609

Phone

(212) 304-0101

Fax

(212) 304-0788

NPI assigned

Jun 4, 2008

Organization subpart

No

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

Authorized official

Name

Jose Luis Susana

Title

President

Phone

(212) 304-0101

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• JOSE PHARMACY AND SURIGAL SUPPLY Doing business as

Medicare fee-for-service enrollment

Enrolled in NY2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Howard Allen Goldman, RPH

  • Pharmacist
  • New York, NY
  • NPI 1467611202
  NPD (past)

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

{
    "created_epoch": "1212537600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578441600000",
    "number": "1356500425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506 W 207TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100342609",
            "telephone_number": "212-304-0101",
            "fax_number": "212-304-0788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 W 207TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100342609",
            "telephone_number": "212-304-0101",
            "fax_number": "212-304-0788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JRA DRUG CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-04",
        "last_updated": "2020-01-08",
        "certification_date": "2020-01-08",
        "status": "A",
        "authorized_official_last_name": "SUSANA",
        "authorized_official_first_name": "JOSE",
        "authorized_official_middle_name": "LUIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "212-304-0101"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NY",
            "license": "042575",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "028965",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "3358113",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2978976",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "JOSE PHARMACY AND SURIGAL SUPPLY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "JOSE PHARMACY AND SURIGAL SUPPLY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in New York, NY
• Providers in New York, NY by specialty
• Community/Retail Pharmacy in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.