Jafa Pharmaceuticals, Inc.

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

Legal business name

JAFA PHARMACEUTICALS, INC.

Practice address

95 Montgomery Dr Ste 108
Santa Rosa, CA 95404-6617

Phone

(707) 525-1130

Fax

(707) 525-8099

NPI assigned

Mar 13, 2020

Organization subpart

No

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

Authorized official

Name

Tony Ibrahim

Title

Ceo

Phone

(760) 987-6796

Specialties & licenses 1

Addresses

Other names 1

• CREEKSIDE PHARMACY Doing business as

Tax ID family

Creekside Pharmacy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Jafa Pharmaceuticals, Inc.

  • Community/Retail Pharmacy
  • Santa Rosa, CA
  • NPI 1497814594
  NPD tax ID

Locations

Practitioners 1

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

• Anyamanee Malakham, RPH

  • Pharmacist
  • Santa Rosa, CA
  • NPI 1376209619
  NPD

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

{
    "created_epoch": "1584057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1584057600000",
    "number": "1629604368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 MONTGOMERY DR STE 108",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954046617",
            "telephone_number": "707-525-1130",
            "fax_number": "707-525-8099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 MONTGOMERY DR STE 108",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954046617",
            "telephone_number": "707-525-1130",
            "fax_number": "707-525-8099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAFA PHARMACEUTICALS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-13",
        "last_updated": "2020-03-13",
        "certification_date": "2020-03-13",
        "status": "A",
        "authorized_official_last_name": "IBRAHIM",
        "authorized_official_first_name": "TONY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "760-987-6796"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CREEKSIDE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Joshua Jacober, MD
• Gerald D. Jacobs
• Robert Louis Jacobs
• Mark Edwin Jacobson, MD
• Jafa Pharmaceuticals, Inc.
• Mahsa Sadat Jafari
• Robert Torin Jaffe, M.D.
• Ida Jahed, MD
• Lucelene Jaimes Perez
• Fary Jalili

• Long Term Care Pharmacy in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Long Term Care Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2020; 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.