Mary & Joseph Food and Drug Company, LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

MARY & JOSEPH FOOD AND DRUG COMPANY, LLC

Practice address

10210 N 32ND St Ste C7
Phoenix, AZ 85028-3826

Phone

(602) 675-0887

Fax

(602) 610-5844

NPI assigned

Jun 11, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Timothy Joseph Youkhana, PHARM. D.NPI 1518247097

Title

Owner

Phone

(602) 675-0887

Specialties & licenses 5

Addresses

Other identifiers 1

Other names 2

• A Nice Apothecary Doing business as
• Scaled Enterprise Solutions Former legal business name

Tax ID family

A Nice Apothecary2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Annice Apothecary & Deli

  • Pharmacist
  • Skokie, IL
  • NPI 1972979169
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Timothy Joseph Youkhana, PHARM. D.

  • Pharmacist
  • Skokie, IL
  • NPI 1518247097
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1528675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601856000000",
    "number": "1073006557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10210 N 32ND ST STE C7",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850283826",
            "telephone_number": "602-675-0887",
            "fax_number": "602-610-5844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10210 N 32ND ST STE C7",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850283826",
            "telephone_number": "602-675-0887",
            "fax_number": "602-610-5844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY & JOSEPH FOOD AND DRUG COMPANY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-11",
        "last_updated": "2020-10-05",
        "certification_date": "2020-10-05",
        "status": "A",
        "authorized_official_last_name": "YOUKHANA",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "602-675-0887",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARM. D."
    },
    "taxonomies": [
        {
            "code": "332800000X",
            "taxonomy_group": "",
            "desc": "Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy",
            "state": "AZ",
            "license": "Y007596",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2178043",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "A Nice Apothecary",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Scaled Enterprise Solutions",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Scaled Enterprise Solutions",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Scaled Enterprise Solutions",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Community/Retail Pharmacy in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Community/Retail Pharmacy in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.