Provider Demographics
NPI:1538204656
Name:JPE PHARMACY INC.
Entity type:Organization
Organization Name:JPE PHARMACY INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SUPERVSING PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:J
Authorized Official - Last Name:ESPINOSA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-379-3333
Mailing Address - Street 1:51 SOUTH MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:FREEPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11520
Mailing Address - Country:US
Mailing Address - Phone:516-379-3333
Mailing Address - Fax:516-379-3387
Practice Address - Street 1:51 SOUTH MAIN STREET
Practice Address - Street 2:
Practice Address - City:FREEPORT
Practice Address - State:NY
Practice Address - Zip Code:11520
Practice Address - Country:US
Practice Address - Phone:516-379-3333
Practice Address - Fax:516-379-3387
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2010-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014337183500000X, 333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes333600000XSuppliersPharmacy
No183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00379277Medicaid