Provider Demographics
NPI:1043763634
Name:OLIVER, JOSHUA (PHARMD)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:
Last Name:OLIVER
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 1:701 E. 6TH STREET
Mailing Address - Street 2:
Mailing Address - City:MCLAUGHLIN
Mailing Address - State:SD
Mailing Address - Zip Code:57642
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:701 E. 6TH STREET
Practice Address - Street 2:
Practice Address - City:MCLAUGHLIN
Practice Address - State:SD
Practice Address - Zip Code:57642
Practice Address - Country:US
Practice Address - Phone:605-823-4458
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-29
Last Update Date:2016-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDRPH5865183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist