1598941510 NPI number — PJF MANAGEMENT INC

Table of content: (NPI 1598941510)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598941510 NPI number — PJF MANAGEMENT INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PJF MANAGEMENT INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
THE FRIENDLY PHARMACY
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1598941510
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/20/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3302 BOCA CHICA BLVD
Provider Second Line Business Mailing Address:
STE 107
Provider Business Mailing Address City Name:
BROWNSVILLE
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78521-5193
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
956-544-1200
Provider Business Mailing Address Fax Number:
956-544-5005

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3302 BOCA CHICA BLVD
Provider Second Line Business Practice Location Address:
STE 107
Provider Business Practice Location Address City Name:
BROWNSVILLE
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78521-5193
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
956-544-1200
Provider Business Practice Location Address Fax Number:
956-544-5005
Provider Enumeration Date:
01/22/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
FRASER
Authorized Official First Name:
PAULA
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER, PIC
Authorized Official Telephone Number:
956-544-1200

Provider Taxonomy Codes

  • Taxonomy code: 333600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0003X , with the licence number: 25857 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2101108 . This is a "PK" identifier . This identifiers is of the category "OTHER".
  • Identifier: 145874 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 45103294 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".