Provider Demographics
NPI:1497412597
Name:JOELTON PHARMACY LLC
Entity Type:Organization
Organization Name:JOELTON PHARMACY LLC
Other - Org Name:JOELTON PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:UJWALKUMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:PANHALKAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-403-9687
Mailing Address - Street 1:3515 OLD CLARKSVILLE PIKE STE A
Mailing Address - Street 2:
Mailing Address - City:JOELTON
Mailing Address - State:TN
Mailing Address - Zip Code:37080-8892
Mailing Address - Country:US
Mailing Address - Phone:615-502-1615
Mailing Address - Fax:615-285-8111
Practice Address - Street 1:3515 OLD CLARKSVILLE PIKE STE A
Practice Address - Street 2:
Practice Address - City:JOELTON
Practice Address - State:TN
Practice Address - Zip Code:37080-8892
Practice Address - Country:US
Practice Address - Phone:615-502-1615
Practice Address - Fax:615-285-8111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-23
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies