Provider Demographics
NPI:1114334927
Name:MARTINO, JOSEPH (RPH)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:MARTINO
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8180 S TRYON ST
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28273-3325
Mailing Address - Country:US
Mailing Address - Phone:704-588-9796
Mailing Address - Fax:
Practice Address - Street 1:8180 S TRYON ST
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28273-3325
Practice Address - Country:US
Practice Address - Phone:704-588-9796
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-14
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC11700183500000X
NY034832183500000X
NC18715183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist