Provider Demographics
NPI:1497873046
Name:JOSHI, RUSHABH R
Entity Type:Individual
Prefix:
First Name:RUSHABH
Middle Name:R
Last Name:JOSHI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:503 N KENTUCKY ST
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:TN
Mailing Address - Zip Code:37763-2630
Mailing Address - Country:US
Mailing Address - Phone:865-376-3034
Mailing Address - Fax:865-376-9591
Practice Address - Street 1:106 W RACE ST
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:TN
Practice Address - Zip Code:37763-2721
Practice Address - Country:US
Practice Address - Phone:865-717-0742
Practice Address - Fax:865-376-9591
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN11758183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist