Provider Demographics
NPI:1326686932
Name:MANNING, JOSHUA BRETT (PHARMD)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:BRETT
Last Name:MANNING
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2340 HIGHWAY 15 N
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MS
Mailing Address - Zip Code:39440-1831
Mailing Address - Country:US
Mailing Address - Phone:601-426-9812
Mailing Address - Fax:601-425-2169
Practice Address - Street 1:KROGER
Practice Address - Street 2:2340 HIGHWAY 15 N
Practice Address - City:LAUREL
Practice Address - State:MS
Practice Address - Zip Code:39440-1831
Practice Address - Country:US
Practice Address - Phone:601-426-9812
Practice Address - Fax:601-425-2169
Is Sole Proprietor?:No
Enumeration Date:2019-12-13
Last Update Date:2020-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE-0105081835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist