Healthcare Provider Details

I. General information

NPI: 1134768831
Provider Name (Legal Business Name): JOYNER RX, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/27/2019
Last Update Date: 06/29/2022
Certification Date: 06/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

185 W COURT AVE
SELMER TN
38375-2133
US

IV. Provider business mailing address

PO BOX 236
SELMER TN
38375-0236
US

V. Phone/Fax

Practice location:
  • Phone: 731-434-0180
  • Fax: 731-484-0181
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: JACK TYLER JOYNER
Title or Position: OWNER/CEO
Credential:
Phone: 731-610-0104