Provider Demographics
NPI:1285304386
Name:JOE'S PHARMACY SERVICES
Entity type:Organization
Organization Name:JOE'S PHARMACY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:CZERW
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:215-642-2422
Mailing Address - Street 1:2401 PENNSYLVANIA AVE STE 1D7
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19130-3000
Mailing Address - Country:US
Mailing Address - Phone:215-642-2422
Mailing Address - Fax:267-792-3197
Practice Address - Street 1:2401 PENNSYLVANIA AVE STE 1D7
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19130-3000
Practice Address - Country:US
Practice Address - Phone:215-642-2422
Practice Address - Fax:267-792-3197
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JOE'S PHARMACY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-09-20
Last Update Date:2021-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1295355428Medicaid