Provider Demographics
NPI:1306946272
Name:JOSHUAS PHARMACY
Entity type:Organization
Organization Name:JOSHUAS PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:MR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:JOSHUA
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:713-771-6014
Mailing Address - Street 1:8200 WEDNESBURY LN STE 104
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-2931
Mailing Address - Country:US
Mailing Address - Phone:713-772-6014
Mailing Address - Fax:713-772-2596
Practice Address - Street 1:8200 WEDNESBURY LN STE 104
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-2931
Practice Address - Country:US
Practice Address - Phone:713-772-6014
Practice Address - Fax:713-772-2596
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX37034183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX145016Medicaid