Healthcare Provider Details

I. General information

NPI: 1528938099
Provider Name (Legal Business Name): JOY CAO
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/10/2025
Last Update Date: 11/10/2025
Certification Date: 11/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3400 SPRUCE ST
PHILADELPHIA PA
19104-4238
US

IV. Provider business mailing address

300 S 41ST ST # 2A
PHILADELPHIA PA
19104-4014
US

V. Phone/Fax

Practice location:
  • Phone: 609-751-7598
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP459378
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: