Healthcare Provider Details

I. General information

NPI: 1124271135
Provider Name (Legal Business Name): JOHANNA MOJICA PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JOHANNA RODRIGUEZ

II. Dates (important events)

Enumeration Date: 11/04/2008
Last Update Date: 01/06/2025
Certification Date: 01/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 ROCKFORD DR
NEWARK DE
19713-2120
US

IV. Provider business mailing address

1700 W MATISSE DR
MIDDLETOWN DE
19709-0060
US

V. Phone/Fax

Practice location:
  • Phone: 302-996-5480
  • Fax:
Mailing address:
  • Phone: 646-372-7970
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0004948
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: