Provider Demographics
NPI:1104852821
Name:JOSEPHS DRUGS INC
Entity Type:Organization
Organization Name:JOSEPHS DRUGS INC
Other - Org Name:WOODHAVEN PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:TESTA
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:718-846-7777
Mailing Address - Street 1:86 22 JAMAICA AVE
Mailing Address - Street 2:
Mailing Address - City:WOODHAVEN
Mailing Address - State:NY
Mailing Address - Zip Code:11421
Mailing Address - Country:US
Mailing Address - Phone:718-846-7777
Mailing Address - Fax:718-849-8725
Practice Address - Street 1:86 22 JAMAICA AVE
Practice Address - Street 2:
Practice Address - City:WOODHAVEN
Practice Address - State:NY
Practice Address - Zip Code:11421
Practice Address - Country:US
Practice Address - Phone:718-846-7777
Practice Address - Fax:718-849-8725
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-24
Last Update Date:2013-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NY0236263336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01828660Medicaid
2063220OtherPK