Provider Demographics
NPI:1629580006
Name:HENDRICKSON, JOSHUA AARON (PHARM D)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:AARON
Last Name:HENDRICKSON
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:950 PROGRESS ST APT 106
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15212-7904
Mailing Address - Country:US
Mailing Address - Phone:906-281-6735
Mailing Address - Fax:
Practice Address - Street 1:1400 LOCUST ST
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15219-5114
Practice Address - Country:US
Practice Address - Phone:412-232-8424
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-25
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26027242A183500000X
PARP454877183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN26027242AOtherIN BOARD OF PHARMACY
TX62532OtherTX BOARD OF PHARMACY
PARP454877OtherPA BOARD OF PHARMACY