Provider Demographics
NPI:1396034294
Name:JOSENDAHL, JAMES A (RPH)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:A
Last Name:JOSENDAHL
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 1:58 FIR CIR
Mailing Address - Street 2:
Mailing Address - City:MINERAL
Mailing Address - State:VA
Mailing Address - Zip Code:23117-4645
Mailing Address - Country:US
Mailing Address - Phone:540-894-4931
Mailing Address - Fax:
Practice Address - Street 1:705 DOMINION SQ
Practice Address - Street 2:
Practice Address - City:CULPEPER
Practice Address - State:VA
Practice Address - Zip Code:22071
Practice Address - Country:US
Practice Address - Phone:540-825-0703
Practice Address - Fax:540-825-2915
Is Sole Proprietor?:No
Enumeration Date:2011-03-31
Last Update Date:2011-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202004778183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist