Jai Jagannath Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

31851 Issued in TX

Legal business name

JAI JAGANNATH INC

Practice address

3635 N Belt Line Rd Ste 100
Sunnyvale, TX 75182-9235

Phone

(972) 290-0341

Fax

(972) 290-0351

NPI assigned

Feb 12, 2018

Organization subpart

No

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

Authorized official

Name

Mr. Srinivasa Rao Komirisetty

Title

President

Phone

(972) 290-0341

Specialties & licenses 1

Addresses

Other names 1

• SUNNYVALE PHARMACY Doing business as

Locations

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

{
    "created_epoch": "1518393600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1518393600000",
    "number": "1639679079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3635 N BELT LINE RD STE 100",
            "city": "SUNNYVALE",
            "state": "TX",
            "postal_code": "751829235",
            "telephone_number": "972-290-0341",
            "fax_number": "972-290-0351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3635 N BELT LINE RD STE 100",
            "city": "SUNNYVALE",
            "state": "TX",
            "postal_code": "751829235",
            "telephone_number": "972-290-0341",
            "fax_number": "972-290-0351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAI JAGANNATH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-12",
        "last_updated": "2018-02-12",
        "status": "A",
        "authorized_official_last_name": "KOMIRISETTY",
        "authorized_official_first_name": "SRINIVASA RAO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "972-290-0341",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TX",
            "license": "31851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SUNNYVALE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Sunnyvale, TX
• Providers in Sunnyvale, TX by specialty
• Community/Retail Pharmacy in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2018; 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.