NPI 1134489214

Jencare Neighborhood Medical South Park LLC

Organisation Non-Pharmacy Dispensing Site Colonial Heights, VA

Practice location

Address: 524 Southpark Blvd, Colonial Heights, VA 23834-3609
Phone: (305) 653-1770
Mailing address: 1395 NW 167th St, Miami, FL 33169-5710

Authorised official

Name: Mary Chen
Title: Authorized Official
Phone: (305) 831-4722

Registered specialties (3)

Non-Pharmacy Dispensing Site Primary

Suppliers Taxonomy 332900000X

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Internal Medicine Physician

Allopathic & Osteopathic Physicians Taxonomy 207R00000X

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Community/Retail Pharmacy

Suppliers Taxonomy 3336C0003X

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Registry record

NPI: 1134489214
Entity type: Organization
NPI issued: 22 May 2012
Record last updated: 20 Feb 2025

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.