Jackson Pharmacy Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

JACKSON PHARMACY INC.

Practice address

7102
37TH Avenue
Jackson Heights, NY 11372

Phone

(718) 255-6723

Fax

(718) 255-6784

NPI assigned

Oct 3, 2018

Organization subpart

No

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

Authorized official

Name

Mr. Abdul H Khan

Title

President

Phone

(718) 255-6723

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY2 enrollments

Enrollment records 2

Locations

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

{
    "created_epoch": "1538524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1538524800000",
    "number": "1982189171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7102",
            "address_2": "37TH AVENUE",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "11372",
            "telephone_number": "718-255-6723",
            "fax_number": "718-255-6784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7102",
            "address_2": "37TH AVENUE",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "11372",
            "telephone_number": "718-255-6723",
            "fax_number": "718-255-6784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON PHARMACY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-03",
        "last_updated": "2018-10-03",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "ABDUL",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-255-6723",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jackson Heights Vision Associates
• Jackson Heights Vision Express LLC
• Jackson Heights Wellness Chiro P.C.
• Jackson Medical, PLLC
• Jackson Meds Pharmacy Inc
• Charles Jackson, DMD
• Khishigzaya Jacobs
• Jag Orthotics & Prosthetics Inc
• Jai Jeen Rhee, M.D.
• Jaime F Roman MD

• Community/Retail Pharmacy in Jackson Heights, NY
• Providers in Jackson Heights, 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 Oct 3, 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.