Port Jervis Pharmacy Llc
Community/Retail Pharmacy
15 Jersey Ave, Port Jervis
New York, 12771-2436
845-856-6681 845-856-6532
Port Jervis Pharmacy Llc is a Community/Retail Pharmacy in Port Jervis, New York. It is located at 15 Jersey Ave, Port Jervis and it's customer support contact number is 845-856-6681. The authorized person of Port Jervis Pharmacy Llc is Chirag Modi, R.PH. who is Owner of the pharmacy and his contact number is 734-377-2584. Port Jervis Pharmacy Llc accepts medicare which means medicare covered patients will not be billed for any more than the Medicare deductible and coinsurance.
Port Jervis Pharmacy Llc is a pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.
Pharmacy Details:
Port Jervis Pharmacy Llc type, location, contact phone number and fax are as below. Patients can directly walkin to the pharmacy or can call on the below given customer support phone number for enquiries.
| Name: | Port Jervis Pharmacy Llc |
| Type: | Community/Retail Pharmacy |
| Location: | 15 Jersey Ave, Port Jervis,
New York, 12771-2436 |
| Phone: | 845-856-6681 |
| Fax: | 845-856-6532 |
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints of this pharmacy is as below. Person's position and contact details are also mentioned below.
| Name: | Chirag Modi |
| Credentials: | R.PH. |
| Position: | Owner |
| Contact Number: | 734-377-2584 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details of given pharmacy are as mentioned below.
| NPI Number: | 1053426098 |
| NPI Enumeration Date: | 20 Aug, 2006 |
| NPI Last Update On: | 07 Mar, 2023 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Port Jervis Pharmacy Llc are as mentioned below.
| Specialization | License Number | State | Status | |
| Community/Retail Pharmacy | | | Primary | |
| Pharmacy | 024124 | New York | Secondary | |
Other Medical Identifiers:
Other legacy medical identifiers of the pharmacy such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 3374496 | Other | | Other Id Number-commercial Number |
| 01879923 | Medicaid | New York | |
Medicare Enrollment:
Port Jervis Pharmacy Llc is enrolled in medicare and it's Pac Id, enrollment Id, registered name and type is as stated below.
| PAC ID: |
Enrollment ID: |
Org Name | Medicare Entity Type |
| 9335260876 | O20100930020040 | Jakris Inc | DME SUPPLIER - PHARMACY |
| 9335260876 | O20150910000309 | Jakris Inc | PART B SUPPLIER - MASS IMMUNIZATION (ROSTER BILLER ONLY) |
Products Available:
Port Jervis Pharmacy Llc has following products available for sale under medicare.
| Products: |
|---|
| • Blood Glucose Monitors & Supplies: Non-mail Order | • Canes & Crutches |
| • Heat & Cold Applications | • Nebulizer Equipment & Supplies |
| • Orthoses: Off-the-shelf | • Ostomy Supplies |
| • Surgical Dressings | • Urological Supplies |
| • Walkers | |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | 15 Jersey Ave,
Port Jervis, New York |
| Zip: | 12771-2436 |
| Phone Number: | -- |
Patients can reach Port Jervis Pharmacy Llc at
15 Jersey Ave, Port Jervis, New York or can
call on customer care at 845-856-6681.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 December, 2025.