Provider Demographics
NPI:1124628748
Name:ELSWICK, JOSHUA RYAN (RPH)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:RYAN
Last Name:ELSWICK
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 1:4913 CARRIAGE PASS PL
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40299-6638
Mailing Address - Country:US
Mailing Address - Phone:304-610-1817
Mailing Address - Fax:
Practice Address - Street 1:12981 SHELBYVILLE RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40243-1538
Practice Address - Country:US
Practice Address - Phone:304-610-1817
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-01
Last Update Date:2020-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0006344183500000X
IN26023748A183500000X
KY015253183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist