Provider Demographics
NPI:1306898929
Name:KNIGHT, JOSEPH ERVIN (RPH)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:ERVIN
Last Name:KNIGHT
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 1:705 FIRETHORN DR
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:61571-2364
Mailing Address - Country:US
Mailing Address - Phone:309-444-5022
Mailing Address - Fax:
Practice Address - Street 1:20 CHERRY TREE SHOPPING CTR
Practice Address - Street 2:KROGER PHARMACY
Practice Address - City:WASHINGTON
Practice Address - State:IL
Practice Address - Zip Code:61571-2170
Practice Address - Country:US
Practice Address - Phone:309-886-2415
Practice Address - Fax:309-886-2415
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist