Provider Demographics
NPI:1679625925
Name:LA JOYA DRUGS INC
Entity Type:Organization
Organization Name:LA JOYA DRUGS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HIROSHI
Authorized Official - Middle Name:
Authorized Official - Last Name:NAKANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-226-0330
Mailing Address - Street 1:1801 S ASHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60608-2805
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1801 S ASHLAND AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60608-2805
Practice Address - Country:US
Practice Address - Phone:312-226-0330
Practice Address - Fax:312-421-2339
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
IL3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1417054OtherOTHER ID NUMBER-COMMERCIAL NUMBER
1417054OtherOTHER ID NUMBER
1417054OtherOTHER ID NUMBER