Provider Demographics
NPI:1598715260
Name:JOES PHARMACY INC
Entity Type:Organization
Organization Name:JOES PHARMACY INC
Other - Org Name:JOES PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOE
Authorized Official - Middle Name:
Authorized Official - Last Name:SHUNNARAH
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:256-658-0835
Mailing Address - Street 1:27691 CAPSHAW RD
Mailing Address - Street 2:
Mailing Address - City:HARVEST
Mailing Address - State:AL
Mailing Address - Zip Code:35749-7403
Mailing Address - Country:US
Mailing Address - Phone:256-230-3416
Mailing Address - Fax:256-230-3407
Practice Address - Street 1:27691 CAPSHAW RD
Practice Address - Street 2:
Practice Address - City:HARVEST
Practice Address - State:AL
Practice Address - Zip Code:35749-7403
Practice Address - Country:US
Practice Address - Phone:256-230-3416
Practice Address - Fax:256-230-3407
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-11
Last Update Date:2017-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X
AL1127943336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1995870OtherPK
AL100003700Medicaid
AL100003700Medicaid