Provider Demographics
NPI:1669772273
Name:ANDERSON, JOSHUA (PHARM D)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:
Last Name:ANDERSON
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8925 MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:FAIR OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:95628-4009
Mailing Address - Country:US
Mailing Address - Phone:916-965-1541
Mailing Address - Fax:916-965-1798
Practice Address - Street 1:8925 MADISON AVE
Practice Address - Street 2:
Practice Address - City:FAIR OAKS
Practice Address - State:CA
Practice Address - Zip Code:95628-4009
Practice Address - Country:US
Practice Address - Phone:916-965-1541
Practice Address - Fax:916-965-1798
Is Sole Proprietor?:No
Enumeration Date:2010-10-28
Last Update Date:2010-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA52925183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist