Provider Demographics
NPI:1700384237
Name:JOSEFS PHARMACY LLC
Entity Type:Organization
Organization Name:JOSEFS PHARMACY LLC
Other - Org Name:JOSEFS LTC PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:FINNY
Authorized Official - Middle Name:
Authorized Official - Last Name:JOSEPH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-212-2555
Mailing Address - Street 1:2100 NEW BERN AVE
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27610-2431
Mailing Address - Country:US
Mailing Address - Phone:919-610-8975
Mailing Address - Fax:
Practice Address - Street 1:2100 NEW BERN AVE
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27610-2431
Practice Address - Country:US
Practice Address - Phone:919-610-8975
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-30
Last Update Date:2020-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1316240435Medicaid