Provider Demographics
NPI:1346754298
Name:JUBA PHARMACY INC
Entity Type:Organization
Organization Name:JUBA PHARMACY INC
Other - Org Name:JUBA PHARMACY INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:AHMED
Authorized Official - Middle Name:
Authorized Official - Last Name:DAYIB
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:816-377-5388
Mailing Address - Street 1:1926 CHICAGO AVE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55404-1903
Mailing Address - Country:US
Mailing Address - Phone:816-377-5388
Mailing Address - Fax:
Practice Address - Street 1:1926 CHICAGO AVE S
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55404
Practice Address - Country:US
Practice Address - Phone:612-208-0494
Practice Address - Fax:612-545-5527
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-29
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3336C0003XSuppliersPharmacyCommunity/Retail PharmacyGroup - Single Specialty