Provider Demographics
NPI:1023446309
Name:JOULE PHARMACY GROUP INC
Entity type:Organization
Organization Name:JOULE PHARMACY GROUP INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACY MANAGER/OWENER
Authorized Official - Prefix:MRS
Authorized Official - First Name:FREWEINI
Authorized Official - Middle Name:
Authorized Official - Last Name:TEWELDE
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:571-699-3593
Mailing Address - Street 1:1028 S WALTER REED DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22204-0815
Mailing Address - Country:US
Mailing Address - Phone:571-699-3593
Mailing Address - Fax:571-699-3581
Practice Address - Street 1:1028 S WALTER REED DR
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22204-0815
Practice Address - Country:US
Practice Address - Phone:571-699-3593
Practice Address - Fax:855-382-7706
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-23
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202205540183500000X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA7272180001Medicare NSC