Provider Demographics
NPI:1376133686
Name:WALDEN, JOSHUA J (PHARMD)
Entity Type:Individual
Prefix:MR
First Name:JOSHUA
Middle Name:J
Last Name:WALDEN
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 1:1232 E WAGON WHEEL DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85020-4518
Mailing Address - Country:US
Mailing Address - Phone:602-819-5429
Mailing Address - Fax:
Practice Address - Street 1:1300 N 12TH ST STE 406
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85006-2848
Practice Address - Country:US
Practice Address - Phone:602-396-7330
Practice Address - Fax:602-688-8016
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-20
Last Update Date:2021-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202216768183500000X
AZS014299183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist