Provider Demographics
NPI:1467739318
Name:JOHNSON, DUSTIN HOWARD (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:DUSTIN
Middle Name:HOWARD
Last Name:JOHNSON
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 1:600 OLD CLAIRTON RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15236-4313
Mailing Address - Country:US
Mailing Address - Phone:412-655-2151
Mailing Address - Fax:
Practice Address - Street 1:600 OLD CLAIRTON RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15236-4313
Practice Address - Country:US
Practice Address - Phone:412-655-2151
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-07
Last Update Date:2011-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP441977183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist