Provider Demographics
NPI:1225709298
Name:MCNAIR, JOSHUA ALLEN
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:ALLEN
Last Name:MCNAIR
Suffix:
Gender:M
Credentials:
Other - Prefix:DR
Other - First Name:JOSHUA
Other - Middle Name:ALLEN
Other - Last Name:MCNAIR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARMD
Mailing Address - Street 1:6486 BENT TREE DR
Mailing Address - Street 2:
Mailing Address - City:ALLENDALE
Mailing Address - State:MI
Mailing Address - Zip Code:49401-8417
Mailing Address - Country:US
Mailing Address - Phone:616-901-4204
Mailing Address - Fax:
Practice Address - Street 1:2009 HOLTON RD
Practice Address - Street 2:
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49445-1578
Practice Address - Country:US
Practice Address - Phone:231-291-8399
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-21
Last Update Date:2021-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI53020387151835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist