Provider Demographics
NPI:1114543816
Name:GUE, JOSHUA SCOTT (CPHT)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:SCOTT
Last Name:GUE
Suffix:
Gender:M
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1310 COVE LANE RD
Mailing Address - Street 2:
Mailing Address - City:ROARING SPRING
Mailing Address - State:PA
Mailing Address - Zip Code:16673-8300
Mailing Address - Country:US
Mailing Address - Phone:304-964-3897
Mailing Address - Fax:
Practice Address - Street 1:2929 FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:KY
Practice Address - Zip Code:41101-3812
Practice Address - Country:US
Practice Address - Phone:304-964-3897
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-19
Last Update Date:2020-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVPT0008013183700000X
250100103030555183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
250100103030555OtherPHARMACY TECHNICIAN CERTIFICATION BOARD
WVPT0008013OtherREGISTERED PHARMACY TECHNICIAN CERTIFICATE