=====================================================
General NPI Number Information
=====================================================
NPI Number | 1295355428
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JOES PHARMACY
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/17/2020
-----------------------------------------------------
Last Update Date | 02/13/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2401 PENNSYLVANIA AVE
-----------------------------------------------------
City | PHILADELPHIA
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19130-3010
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 267-975-2281
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2401 PENNSYLVANIA AVE STE 1D7
-----------------------------------------------------
City | PHILADELPHIA
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19130-3000
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 267-975-2281
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PHARMACIST IN CHARGE/ OWNER
-----------------------------------------------------
Name | DR. DENNIS M CZERW
-----------------------------------------------------
Credential | PHARMD
-----------------------------------------------------
Telephone | 215-642-2422
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3336C0003X
-----------------------------------------------------
Taxonomy Name | Community/Retail Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------