Provider Demographics
NPI:1083920185
Name:JOSEPH, JUILE
Entity Type:Individual
Prefix:
First Name:JUILE
Middle Name:
Last Name:JOSEPH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:830 BLUFF OAK TRL
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45807-3111
Mailing Address - Country:US
Mailing Address - Phone:419-229-5846
Mailing Address - Fax:419-229-0016
Practice Address - Street 1:302 W ROBB AVE
Practice Address - Street 2:
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45801-2745
Practice Address - Country:US
Practice Address - Phone:419-229-5846
Practice Address - Fax:419-229-0016
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-26
Last Update Date:2010-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03225305183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist