Provider Demographics
NPI:1982850772
Name:JOINT VENTURES PHARMACY INC
Entity Type:Organization
Organization Name:JOINT VENTURES PHARMACY INC
Other - Org Name:HOLZER FAMILY PHARMACY ATHENS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:LEAD SR. CLINICAL PHARMACY TEC
Authorized Official - Prefix:
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:
Authorized Official - Last Name:LUCKEYDOO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-441-3976
Mailing Address - Street 1:2131 E STATE ST
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:OH
Mailing Address - Zip Code:45701-2138
Mailing Address - Country:US
Mailing Address - Phone:740-589-3181
Mailing Address - Fax:740-589-3182
Practice Address - Street 1:2131 E STATE ST
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:OH
Practice Address - Zip Code:45701-2138
Practice Address - Country:US
Practice Address - Phone:740-589-3181
Practice Address - Fax:740-589-3182
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-12
Last Update Date:2017-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0004X
OH0218417003336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2116541OtherPK
OH2848137Medicaid