Provider Demographics
NPI:1154671055
Name:OSTER, JOANN (RPH)
Entity Type:Individual
Prefix:MS
First Name:JOANN
Middle Name:
Last Name:OSTER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:635 ALTA VISTA DR
Mailing Address - Street 2:
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57701-2322
Mailing Address - Country:US
Mailing Address - Phone:605-721-4635
Mailing Address - Fax:
Practice Address - Street 1:1516 E SAINT PATRICK ST
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57703-4136
Practice Address - Country:US
Practice Address - Phone:605-343-6214
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-18
Last Update Date:2012-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD4784183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist