Provider Demographics
NPI:1558391185
Name:JOSEPH, ADLAI PAUL
Entity Type:Individual
Prefix:MR
First Name:ADLAI
Middle Name:PAUL
Last Name:JOSEPH
Suffix:
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:ADLAI
Other - Middle Name:PAUL
Other - Last Name:JOSEPH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:BS PHARM
Mailing Address - Street 1:2214 RUTGERS DR
Mailing Address - Street 2:
Mailing Address - City:BROOMALL
Mailing Address - State:PA
Mailing Address - Zip Code:19008-2921
Mailing Address - Country:US
Mailing Address - Phone:610-353-6625
Mailing Address - Fax:
Practice Address - Street 1:1001 STERIGERE ST
Practice Address - Street 2:
Practice Address - City:NORRISTOWN
Practice Address - State:PA
Practice Address - Zip Code:19401-5300
Practice Address - Country:US
Practice Address - Phone:610-313-5867
Practice Address - Fax:610-313-5862
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP030976L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist