Provider Demographics
NPI:1821086497
Name:JOU PHARMACY INC
Entity Type:Organization
Organization Name:JOU PHARMACY INC
Other - Org Name:SKY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SUPERVISING PHARMACIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:SABINA
Authorized Official - Middle Name:
Authorized Official - Last Name:UNGER
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:718-434-4744
Mailing Address - Street 1:1100 CONEY ISLAND AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-2342
Mailing Address - Country:US
Mailing Address - Phone:718-434-4744
Mailing Address - Fax:718-434-3171
Practice Address - Street 1:1100 CONEY ISLAND AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-2342
Practice Address - Country:US
Practice Address - Phone:718-434-4744
Practice Address - Fax:718-434-3171
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-07
Last Update Date:2019-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02339893Medicaid
NY02339893Medicaid