Provider Demographics
NPI:1306311527
Name:ERNSTER, JOSEPH DAVID (RPH)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:DAVID
Last Name:ERNSTER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 SNELLING AVE N
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55104-1885
Mailing Address - Country:US
Mailing Address - Phone:651-645-8636
Mailing Address - Fax:
Practice Address - Street 1:720 SNELLING AVE N
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55104-1885
Practice Address - Country:US
Practice Address - Phone:651-645-8636
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-04
Last Update Date:2018-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN123386183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist