Provider Demographics
NPI:1831443456
Name:JOY MEDICAL SUPPLY
Entity type:Organization
Organization Name:JOY MEDICAL SUPPLY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:BENSON
Authorized Official - Middle Name:IKENNA
Authorized Official - Last Name:EJINDU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-817-9309
Mailing Address - Street 1:8305 UNIVERSITY EXEC PARK DR
Mailing Address - Street 2:SUITE 340
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28262-1361
Mailing Address - Country:US
Mailing Address - Phone:704-817-9309
Mailing Address - Fax:704-733-9771
Practice Address - Street 1:8305 UNIVERSITY EXEC PARK DR
Practice Address - Street 2:SUITE 340
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262-1361
Practice Address - Country:US
Practice Address - Phone:704-817-9309
Practice Address - Fax:704-733-9771
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-05
Last Update Date:2012-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC172664332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1235494634Medicare NSC