JETKAT, INC. (NPI# 1093866980) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093866980 |
| Entity Type | Organization |
| Organization Name | JETKAT, INC. |
| Other Organization Name | DBA THE PHARMACY SHOP |
| Practice Address |
66 West Ave Canandaigua NY 14424 |
| Practice Telephone | 5853969970 |
| Practice Fax Number | 5853967264 |
| Mailing Telephone | 5853969970 |
| Mailing Fax Number | 5853967264 |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2008-12-11 |
| Authorized Official Name | MR. KIM ANTHONY TENREIRO (SECRETARY JETKAT INC.) |
| Authorized Official Telephone | 5853969970 |
| Authorized Official Credential | RPH. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
NY | Suppliers | |
| N | 333600000X | Pharmacy | 022695 | NY | Suppliers |
| Y | 3336C0004X |
Pharmacy Specialization: Compounding Pharmacy |
22695 | NY | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | NCPDP # | 3395971 | 01 |
| NY | 01593140 | 05 | |
| NY | DEA # | BJ4674582 | 01 |
| Other Name | Type Code |
|---|---|
| DBA The Pharmacy Shop | Doing Business As Name - Organization |
| Street Address |
66 WEST AVE |
| City | CANANDAIGUA |
| State | NY |
| Zip Code | 14424 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134751688 | Crm-canandaigua LLC | Pharmacy | 66 West Ave, Canandaigua, NY 14424-1521 | 2020-02-12 |
| 1306207154 | Laura Cheneil Sandler | Pharmacist | 66 West Ave, Canandaigua, NY 14424-1521 | 2016-03-08 |
| 1235505421 | Kayla Louise Loosmore | Pharmacist | 66 West Ave, Canandaigua, NY 14424-1521 | 2015-08-11 |
| 1427315266 | Crm-canandaigua LLC | Pharmacy | 66 West Ave, Canandaigua, NY 14424-1521 | 2012-04-18 |
| 1881873172 | Kerrie Lynn Peterson | Pharmacist | 66 West Ave, Canandaigua, NY 14424-1521 | 2007-11-02 |
| 1871618066 | Noreen Spiehler | Pharmacist | 66 West Ave, Canandaigua, NY 14424-1521 | 2007-03-20 |
| 1194849182 | Cheryl A Infantino | Pharmacist | 66 West Ave, Canandaigua, NY 14424-1521 | 2007-03-17 |
| 1093870081 | Julie A. English | Pharmacist | 66 West Ave, Canandaigua, NY 14424-1521 | 2006-12-27 |
| 1619046539 | Kim Anthony Tenreiro | Pharmacist | 66 West Ave, Canandaigua, NY 14424-1521 | 2006-11-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730725029 | Stefanie Ann Hook | Nurse Practitioner | 395 West Street, Suite 101, Canandaigua, NY 14424 | 2019-11-21 |
| 1285120618 | Mary Kathleen Woodruff | Counselor | 163 Gibson Street, Canandaigua, NY 14424 | 2018-07-09 |
| 1699260612 | Victoria Record | Nurse Practitioner | 3325 Marvin Sands Dr, Canandaigua, NY 14424 | 2018-06-22 |
| 1649767443 | Liana Irene Schenk | Counselor | 5297 Parkside Drive, Building 400, Suite 408, Canandaigua, NY 14424 | 2018-04-17 |
| 1225534019 | Brook Slaby | Counselor | 5297 Parkside Dr Building 400 Office 411, Canandaigua, NY 14424 | 2018-04-02 |
| 1154839710 | Madasyn Leigh Smith | Physical Therapist | 229 Parrish St Ste 220, Canandaigua, NY 14424 | 2018-01-17 |
| 1295259992 | Melissa Ann Frarey | Licensed Practical Nurse | 4998 Wyffels Road, Canandaigua, NY 14424 | 2017-08-03 |
| 1235674599 | Wendy Williams | Early Intervention Provider Agency | 5145 North Bloomfiled Road, Canandaigua, NY 14424 | 2016-12-22 |
| 1326418252 | Mary Christine Casella | Registered Nurse | 90 West Gibson Street, Canandaigua, NY 14424 | 2015-10-05 |
| 1417351453 | Holly Jean Jackson | Licensed Practical Nurse | 5a Lafayette Avenue, Canandaigua, NY 14424 | 2014-10-20 |
| Find all providers in zip 14424 | ||||
| Taxonomy Code | 3336C0004X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Compounding Pharmacy |
| A pharmacy that specializes in the preparation of components into a drug preparation as the result of a Practitioner’s Prescription Drug Order or initiative based on the Practitioner/Patient/Pharmacist relationship in the course of professional practice. A compounding pharmacy utilizes specialized equipment and specially designed facilities necessary to meet the legal and quality requirements of its scope of compounding practice. |
| Notes: Sources: NABP Model Practice Act, Appendix C - Good Compounding Practice, USP <795> and <797>, and Pharmacy Compounding Accreditation Board [7/1/2006: new] |
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| 1407412802 | Corner Chemists Pharmacy LLC | Pharmacy | 11 Henry Street, New York, NY 10038 | 2019-05-13 |
| 1255802153 | Realvalue Patients Pharmacy Inc | Pharmacy | 9401 37th Ave Unit 7, Jackson Heights, NY 11372-7917 | 2018-12-17 |
| 1508337023 | Gigi Specialty Pharmacy Corp. | Pharmacy | 55 Page Ave, Staten Island, NY 10309-2611 | 2018-12-10 |
| 1740756576 | Allday Pharmacy Inc | Pharmacy | 4199 Main St, Suite 202a, Flushing, NY 11355 | 2018-10-19 |
| 1700381712 | Planet Rx LLC | Pharmacy | 2813 Cropsey Ave, Brooklyn, NY 11214-7213 | 2018-03-30 |
| 1467955385 | Avchemists LLC | Pharmacy | 68-28 Myrtle Ave, Glendale, NY 11385 | 2018-03-16 |
| 1134622079 | Evers Cambria Inc | Pharmacy | 20807b Linden Blvd, Cambria Heights, NY 11411 | 2018-03-16 |
| 1548707516 | Cmv Pharmacy Inc | Pharmacy | 1017 Madison Marketplace, Hamilton, NY 13346-2343 | 2017-01-27 |
| 1922461540 | Katonah Pharmacy Inc | Pharmacy | 202 Katonah Ave, Katonah, NY 10536-2110 | 2016-03-31 |
| 1295198828 | Advanced Pharmacy Inc | Pharmacy | 6929 Myrtle Ave, Glendale, NY 11385-7265 | 2016-03-31 |
| Find all providers with the same taxonomy | ||||
| City | CANANDAIGUA |
| Zip Code | 14424 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.