Provider Demographics
NPI:1669625927
Name:JOERNS LLC
Entity Type:Organization
Organization Name:JOERNS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SR. COUNSEL AND CHIEF COMPLIANCE OF
Authorized Official - Prefix:
Authorized Official - First Name:HANNAH
Authorized Official - Middle Name:VICTORIA
Authorized Official - Last Name:HAYNES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-249-0663
Mailing Address - Street 1:2430 WHITEHALL PARK DR STE 100
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28273-3948
Mailing Address - Country:US
Mailing Address - Phone:704-249-0663
Mailing Address - Fax:818-455-0640
Practice Address - Street 1:2750 S 18TH PL
Practice Address - Street 2:SUITE 150
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85034-4013
Practice Address - Country:US
Practice Address - Phone:800-966-6662
Practice Address - Fax:818-455-0640
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-30
Last Update Date:2022-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ381909Medicaid