Provider Demographics
NPI:1508009994
Name:JOVIC PHARMACY INC.
Entity Type:Organization
Organization Name:JOVIC PHARMACY INC.
Other - Org Name:JOVIC PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST-IN-CHARGE/ CO OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOY
Authorized Official - Middle Name:A
Authorized Official - Last Name:ABOLO
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:281-441-5100
Mailing Address - Street 1:9816 MEMORIAL BLVD STE 203
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77338-4206
Mailing Address - Country:US
Mailing Address - Phone:281-441-5100
Mailing Address - Fax:281-441-7300
Practice Address - Street 1:9816 MEMORIAL BLVD STE 203
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-4206
Practice Address - Country:US
Practice Address - Phone:281-441-5100
Practice Address - Fax:281-441-7300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-14
Last Update Date:2009-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX264023336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXLICENSE # 26402OtherTEXAS STATE BOARD OF PHARMACY