Provider Demographics
NPI:1164799664
Name:BAROUDI, JOSETTE CHARLES (RPH)
Entity Type:Individual
Prefix:MISS
First Name:JOSETTE
Middle Name:CHARLES
Last Name:BAROUDI
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 1:1262 LITITZ PIKE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-4340
Mailing Address - Country:US
Mailing Address - Phone:973-462-2217
Mailing Address - Fax:973-299-7686
Practice Address - Street 1:1262 LITITZ PIKE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-4340
Practice Address - Country:US
Practice Address - Phone:973-462-2217
Practice Address - Fax:973-299-7686
Is Sole Proprietor?:No
Enumeration Date:2011-11-28
Last Update Date:2011-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP445216183500000X
NJ28RI03334100183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist