Jeh-Nissi Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PH24379 Issued in FL

Legal business name

JEH-NISSI INC

Practice address

1357 S Parsons Ave
Seffner, FL 33584

Phone

(813) 409-3829

Fax

(813) 409-3841

NPI assigned

Jan 15, 2010

Organization subpart

No

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

Authorized official

Name

Mr. Ronald Joseph Burris

Title

Owner/President

Phone

(813) 499-1980

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Prestige Pharmacy Doing business as

Locations

Networks

• Optimum HealthCare HMO NetworkPlans: Optimum Diamond Rewards (HMO C-SNP) (H5594-028-000, H5594); Optimum Diamond (HMO C-SNP) (H5594-036-000, H5594); Optimum Diamond Rewards (HMO C-SNP) (H5594-034-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-029-000, H5594); Optimum Platinum Plan (HMO) (H5594-002-000, H5594); Optimum Gold Plus Plan (HMO) (H5594-032-000, H5594); Optimum Diamond Savings COPD (HMO C-SNP) (H5594-031-000, H5594); Optimum Diamond Savings (HMO C-SNP) (H5594-030-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-035-000, H5594)
• Freedom Health HMO NetworkPlans: Freedom Platinum Rewards Plan Rx (HMO) (H5427-102-000, H5427); Freedom VIP Care (HMO C-SNP) (H5427-070-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-108-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-099-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-107-000, H5427); Freedom Maximo (HMO-POS) (H5427-113-000, H5427); Freedom Savings Plan (HMO) (H5427-052-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-096-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-105-000, H5427); Freedom Medi-Medi Full (HMO D-SNP) (H5427-087-000, H5427)…

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

{
    "created_epoch": "1263513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723161600000",
    "number": "1619208568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1357 S PARSONS AVE",
            "city": "SEFFNER",
            "state": "FL",
            "postal_code": "33584",
            "telephone_number": "813-409-3829",
            "fax_number": "813-409-3841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1357 S PARSONS AVE",
            "city": "SEFFNER",
            "state": "FL",
            "postal_code": "33584",
            "telephone_number": "813-409-3829",
            "fax_number": "813-409-3841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEH-NISSI INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-15",
        "last_updated": "2024-08-09",
        "certification_date": "2024-08-05",
        "status": "A",
        "authorized_official_last_name": "BURRIS",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "813-499-1980",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "FL",
            "license": "PH24379",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "1052593",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002065500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prestige Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Idelis Fedeslinda Arias de la Torre
• Ruxandra Ivascu, PHARMD
• Sharica Y Jackson
• Holly Jansen, M.S. CCC-SLP
• Kamillia Kasndra Jefferies
• Jinnah Life Care Commuinty
• Agatha Jones
• Madison Jones, PHARMD
• Shavonda Jones, MS, CCC-SLP
• Tony L Jones Jr., PTA

• Community/Retail Pharmacy in Seffner, FL
• Providers in Seffner, FL by specialty
• Community/Retail Pharmacy in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2024; 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.