JW Spark II LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

JW SPARK II LLC

Practice address

15007 Northern Blvd
Flushing, NY 11354-4968

Phone

(718) 358-3800

Fax

(718) 358-2999

NPI assigned

Nov 28, 2018

Organization subpart

No

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

Authorized official

Name

Jason ParkNPI 1023228160

Title

Memeber

Phone

(718) 358-3800

Specialties & licenses 1

Addresses

Other names 1

• Smile Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in NY2 enrollments

Enrollment records 2

Practitioners 6

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

• Jason Park, R.PH.

  • Pharmacist
  • Flushing, NY
  • NPI 1023228160
  NPD Authorized official
• Sarah Youngeun Chin, PHARM. D.

  • Pharmacist
  • Rye, NY
  • NPI 1275306235
  NPD (past)
• Ji Won Jeon

  • Pharmacist
  • Flushing, NY
  • NPI 1417416850
  NPD (past)
• Gabin Koh, RPH

  • Pharmacist
  • Flushing, NY
  • NPI 1275246928
  NPD (past)
• Tae H Lee, RPH

  • Pharmacist
  • Flushing, NY
  • NPI 1659554590
  NPD (past)
• Yongwoo Lee, PHARMD

  • Pharmacist
  • Flushing, NY
  • NPI 1518650795
  NPD (past)

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

{
    "created_epoch": "1543363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1543363200000",
    "number": "1770053134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15007 NORTHERN BLVD",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113544968",
            "telephone_number": "718-358-3800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15007 NORTHERN BLVD",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113544968",
            "telephone_number": "718-358-3800",
            "fax_number": "718-358-2999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JW SPARK II LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-28",
        "last_updated": "2018-11-28",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "MEMEBER",
        "authorized_official_telephone_number": "718-358-3800"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Smile Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jennifer Jusino, PHYSICIAN ASSISTANT
• Shirley Juste
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• Community/Retail Pharmacy in Flushing, NY
• Providers in Flushing, NY by specialty
• Community/Retail Pharmacy in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2018; 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.

Verify at the official NPI Registry.