Provider Demographics
NPI:1629859970
Name:MADALINSKI, JOSHUA JAMES
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:JAMES
Last Name:MADALINSKI
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:PO BOX 121
Mailing Address - Street 2:
Mailing Address - City:HARRIS
Mailing Address - State:MI
Mailing Address - Zip Code:49845-0121
Mailing Address - Country:US
Mailing Address - Phone:906-295-1123
Mailing Address - Fax:
Practice Address - Street 1:601 N LINCOLN RD
Practice Address - Street 2:
Practice Address - City:ESCANABA
Practice Address - State:MI
Practice Address - Zip Code:49829-1426
Practice Address - Country:US
Practice Address - Phone:906-295-1123
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-12
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302415405183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist