Active NPI
Jojan Pharma Inc
- Community/Retail Pharmacy
- Brooklyn, NY
National Provider Identifier
1689978645
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 17-030756
- Legal business name
- JOJAN PHARMA INC
- Practice address
- 121 Saint Nicholas Ave
Brooklyn, NY 11237-4043 - Phone
- (201) 780-7210
- NPI assigned
- Jan 6, 2011
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Rathna Veeramachanani
- Title
- President
- Phone
- (201) 780-7210
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | 17-030756 | NY | Primary |
| Specialty Pharmacy | 3336S0011X | 17-030756 | NY |
Addresses
Primary practice location
121 Saint Nicholas Ave
Brooklyn, NY 11237-4043
Mailing address
121 Saint Nicholas Ave
Brooklyn, NY 11237-4043
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 03305451 | Medicaid | NY |
Other names 1
- ST JUDE PHARMACY
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 3
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20111006000237 | NY | DME Supplier - Pharmacy | 2264604727 | Practice locations: Brooklyn, NY |
| O20140630000667 | NY | Part B Supplier - Mass Immunization (Roster Biller Only) | 2264604727 | Practice locations: Brooklyn, NY |
| O20201207001065 | NY | Part B Supplier - Independent Clinical Laboratory | 2264604727 | Practice locations: Brooklyn, NY |
National Provider Directory
National Provider Directory- Tax ID family
- Jojan Pharma Inc
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Specialty Pharmacy
- Brooklyn, NY
- NPI 1104377571
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1294272000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1445904000000",
"number": "1689978645",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "121 SAINT NICHOLAS AVE",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112374043"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "121 SAINT NICHOLAS AVE",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112374043",
"telephone_number": "201-780-7210"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "JOJAN PHARMA INC",
"organizational_subpart": "NO",
"enumeration_date": "2011-01-06",
"last_updated": "2015-10-27",
"status": "A",
"authorized_official_last_name": "VEERAMACHANANI",
"authorized_official_first_name": "RATHNA",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "201-780-7210"
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": null,
"license": null,
"primary": false
},
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": null,
"license": null,
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "NY",
"license": "17-030756",
"primary": true
},
{
"code": "3336S0011X",
"taxonomy_group": "",
"desc": "Pharmacy, Specialty Pharmacy",
"state": "NY",
"license": "17-030756",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "03305451",
"state": "NY"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "ST JUDE PHARMACY",
"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 Oct 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.