Provider Demographics
NPI:1902554991
Name:JS CAPITAL GROUP
Entity Type:Organization
Organization Name:JS CAPITAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:PADIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-235-4443
Mailing Address - Street 1:2089 VALE RD STE 31
Mailing Address - Street 2:
Mailing Address - City:SAN PABLO
Mailing Address - State:CA
Mailing Address - Zip Code:94806-3875
Mailing Address - Country:US
Mailing Address - Phone:510-235-4443
Mailing Address - Fax:510-235-5527
Practice Address - Street 1:2089 VALE RD STE 31
Practice Address - Street 2:
Practice Address - City:SAN PABLO
Practice Address - State:CA
Practice Address - Zip Code:94806-3875
Practice Address - Country:US
Practice Address - Phone:510-235-4443
Practice Address - Fax:510-235-5527
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JS CAPITAL GROUP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-03-17
Last Update Date:2022-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy