Provider Demographics
NPI:1801838685
Name:JOIA PHARMACY INC
Entity Type:Organization
Organization Name:JOIA PHARMACY INC
Other - Org Name:SOHO PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:YONG
Authorized Official - Middle Name:
Authorized Official - Last Name:XU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-219-0095
Mailing Address - Street 1:3 WALKER ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-2422
Mailing Address - Country:US
Mailing Address - Phone:212-219-0095
Mailing Address - Fax:212-219-0766
Practice Address - Street 1:3 WALKER ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-2422
Practice Address - Country:US
Practice Address - Phone:212-219-0095
Practice Address - Fax:212-219-0766
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-13
Last Update Date:2010-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NY0230893336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
3379460OtherNCPDP PROVIDER IDENTIFICATION NUMBER
NY01717922Medicaid