Provider Demographics
NPI:1104341809
Name:PROFITT, JOSHUA SETH (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:SETH
Last Name:PROFITT
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3200 TODDS RD APT 1005
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509-8420
Mailing Address - Country:US
Mailing Address - Phone:606-481-1157
Mailing Address - Fax:
Practice Address - Street 1:6401 POLO CLUB LN
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-8561
Practice Address - Country:US
Practice Address - Phone:859-294-0510
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-03
Last Update Date:2017-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY019300183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist