Joseliglo Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHRE010162 Issued in GA

Legal business name

JOSELIGLO INC

Practice address

1714 Manchester Expy
Columbus, GA 31904-6748

Phone

(706) 225-0022

Fax

(706) 225-0020

NPI assigned

Dec 23, 2010

Organization subpart

No

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

Authorized official

Name

Mojisola Evbuomwan, PHARMD

Title

President

Phone

(706) 323-0306

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Open Gate Pharmacy #3 Doing business as

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

{
    "created_epoch": "1293062400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730851200000",
    "number": "1881998318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2051 10TH AVE",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319011459",
            "telephone_number": "706-323-0306",
            "fax_number": "706-327-3824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1714 MANCHESTER EXPY",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319046748",
            "telephone_number": "706-225-0022",
            "fax_number": "706-225-0020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOSELIGLO INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-23",
        "last_updated": "2024-11-06",
        "certification_date": "2024-11-06",
        "status": "A",
        "authorized_official_last_name": "EVBUOMWAN",
        "authorized_official_first_name": "MOJISOLA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "706-323-0306",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "GA",
            "license": "PHRE010162",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2153699",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003167027A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Open Gate Pharmacy #3",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jacqueline Jordan, MA
• Joycelyn Denise Jordan
• Terri Gurrola Jordan, PA-C, MPAS, APA
• Tremaine Jordan
• Channelle Jose
• Joseph S. Hurst, M.D.,P.C.
• Alphonsa Joseph, FNP
• Josephine Joseph
• Yolanda Joseph, LPN
• Loyita Josey

• Community/Retail Pharmacy in Columbus, GA
• Providers in Columbus, GA by specialty
• Community/Retail Pharmacy in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2024; 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.