Provider Demographics
NPI:1073155644
Name:JONES, JOSH (PHARM-D)
Entity Type:Individual
Prefix:
First Name:JOSH
Middle Name:
Last Name:JONES
Suffix:
Gender:M
Credentials:PHARM-D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1408 GOAT ROCK RD
Mailing Address - Street 2:
Mailing Address - City:FORTSON
Mailing Address - State:GA
Mailing Address - Zip Code:31808-4216
Mailing Address - Country:US
Mailing Address - Phone:706-905-7819
Mailing Address - Fax:
Practice Address - Street 1:203 COMMERCE AVE STE A
Practice Address - Street 2:
Practice Address - City:LAGRANGE
Practice Address - State:GA
Practice Address - Zip Code:30241-2358
Practice Address - Country:US
Practice Address - Phone:706-883-6178
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-15
Last Update Date:2020-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA023807183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist