Provider Demographics
NPI:1639450661
Name:FURTADO, JOSEPH E JR (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:E
Last Name:FURTADO
Suffix:JR
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:PO BOX 1567
Mailing Address - Street 2:
Mailing Address - City:INYOKERN
Mailing Address - State:CA
Mailing Address - Zip Code:93527-1567
Mailing Address - Country:US
Mailing Address - Phone:760-377-4721
Mailing Address - Fax:
Practice Address - Street 1:1109 N CHINA LAKE BLVD
Practice Address - Street 2:
Practice Address - City:RIDGECREST
Practice Address - State:CA
Practice Address - Zip Code:93555-3131
Practice Address - Country:US
Practice Address - Phone:760-446-4141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-04
Last Update Date:2017-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA61701183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist