Provider Demographics
NPI:1912066168
Name:JIUNTA'S PHARMACY, INC.
Entity Type:Organization
Organization Name:JIUNTA'S PHARMACY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:LIGOTSKI
Authorized Official - Suffix:JR
Authorized Official - Credentials:RPH
Authorized Official - Phone:570-823-1116
Mailing Address - Street 1:342 CAREY AVE
Mailing Address - Street 2:
Mailing Address - City:WILKES BARRE
Mailing Address - State:PA
Mailing Address - Zip Code:18702-2133
Mailing Address - Country:US
Mailing Address - Phone:570-823-1116
Mailing Address - Fax:570-812-0229
Practice Address - Street 1:342 CAREY AVE
Practice Address - Street 2:
Practice Address - City:WILKES BARRE
Practice Address - State:PA
Practice Address - Zip Code:18702-2133
Practice Address - Country:US
Practice Address - Phone:570-823-1116
Practice Address - Fax:570-823-0229
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2008-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPP-413129-L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0152240001Medicare NSC