Provider Demographics
NPI:1306573944
Name:GONINAN, JOSHUA (PHARMD)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:
Last Name:GONINAN
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 1:5312 VIRGINIA DARE TRL N
Mailing Address - Street 2:
Mailing Address - City:KITTY HAWK
Mailing Address - State:NC
Mailing Address - Zip Code:27949-5917
Mailing Address - Country:US
Mailing Address - Phone:252-261-8900
Mailing Address - Fax:
Practice Address - Street 1:5312 VIRGINIA DARE TRL N
Practice Address - Street 2:
Practice Address - City:KITTY HAWK
Practice Address - State:NC
Practice Address - Zip Code:27949-5917
Practice Address - Country:US
Practice Address - Phone:252-261-8900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-03
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC31527183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist