Organization Active NPI

DRJ Pharmacy Inc

  • Community/Retail Pharmacy
  • Brooklyn, NY
National Provider Identifier
1639587819
Registry record updated Jun 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
032981 Issued in NY
Legal business name
DRJ PHARMACY INC
Doing business as
drj pharmacy inc
Practice address
10410 Flatlands Ave
Brooklyn, NY 11236-2822
Phone
(917) 541-2458
Fax
(917) 893-8454
NPI assigned
Jul 31, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2022

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

Authorized official

Name
Dr. Jenniba Jenniba, PHARMD
Title
Pharmacist
Phone
(917) 893-8452

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 032981 NY Primary

Addresses

Primary practice location

10410 Flatlands Ave
Brooklyn, NY 11236-2822

Mailing address

1554 E 45TH St
Brooklyn, NY 11234-3006
Phone (917) 541-2458

Other identifiers 1

IdentifierTypeStateIssuer
04397191MedicaidNY

Other names 1

  • drj pharmacy inc Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20151104000292 NY DME Supplier - Pharmacy 0840500880 Practice locations: Brooklyn, NY
O20220628002280 NY Part B Supplier - Pharmacy 0840500880 Practice locations: Brooklyn, NY

Laboratory certificates & supplier records

Derived by NPIMap

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

SupplierSuppliesMedicare assignment
DRJ Pharmacy Inc10410 Flatlands Ave, Brooklyn, NY 11236-2822(917) 893-8452 Nebulizer Drugs Does not accept assignmentParticipating since Nov 4, 2015

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1406764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655078400000",
    "number": "1639587819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1554 E 45TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112343006",
            "telephone_number": "917-541-2458",
            "fax_number": "917-893-8454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10410 FLATLANDS AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112362822",
            "telephone_number": "917-541-2458",
            "fax_number": "917-893-8454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DRJ PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-31",
        "last_updated": "2022-06-13",
        "certification_date": "2022-06-13",
        "status": "A",
        "authorized_official_last_name": "JENNIBA",
        "authorized_official_first_name": "JENNIBA",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "917-893-8452",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "032981",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04397191",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "drj pharmacy inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2022; 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.