Provider Demographics
NPI:1154412641
Name:WOODFORD, JOSEPH A (RPH)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:A
Last Name:WOODFORD
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:480 E DEARBORN ST
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:34223-3412
Mailing Address - Country:US
Mailing Address - Phone:941-474-3043
Mailing Address - Fax:941-423-2827
Practice Address - Street 1:13221 TAMIAMI TRL
Practice Address - Street 2:
Practice Address - City:NORTH PORT
Practice Address - State:FL
Practice Address - Zip Code:34287-2163
Practice Address - Country:US
Practice Address - Phone:941-426-1123
Practice Address - Fax:941-423-2827
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS10865183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist