Healthcare Provider Details

I. General information

NPI: 1598715260
Provider Name (Legal Business Name): JOES PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2006
Last Update Date: 03/31/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27691 CAPSHAW RD
HARVEST AL
35749-7403
US

IV. Provider business mailing address

27691 CAPSHAW RD
HARVEST AL
35749-7403
US

V. Phone/Fax

Practice location:
  • Phone: 256-230-3416
  • Fax: 256-230-3407
Mailing address:
  • Phone: 256-230-3416
  • Fax: 256-230-3407

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number112794
License Number StateAL

VIII. Authorized Official

Name: JOE SHUNNARAH
Title or Position: OWNER
Credential: RPH
Phone: 256-658-0835