Provider Demographics
NPI:1790796167
Name:JONES PHARMACY ENTERPRISES INC
Entity Type:Organization
Organization Name:JONES PHARMACY ENTERPRISES INC
Other - Org Name:GIANT GENIE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:E
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-525-2704
Mailing Address - Street 1:5123 SOUTH BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28217-2754
Mailing Address - Country:US
Mailing Address - Phone:704-525-2704
Mailing Address - Fax:
Practice Address - Street 1:5123 SOUTH BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28217-2754
Practice Address - Country:US
Practice Address - Phone:704-525-2704
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7703272Medicaid
NC7703272Medicaid