Provider Demographics
NPI:1679163570
Name:GREESON, JOSHUA ZANE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:ZANE
Last Name:GREESON
Suffix:
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 1:990 PINE BARREN RD STE 102
Mailing Address - Street 2:
Mailing Address - City:POOLER
Mailing Address - State:GA
Mailing Address - Zip Code:31322-9448
Mailing Address - Country:US
Mailing Address - Phone:912-348-4420
Mailing Address - Fax:
Practice Address - Street 1:990 PINE BARREN RD STE 102
Practice Address - Street 2:
Practice Address - City:POOLER
Practice Address - State:GA
Practice Address - Zip Code:31322-9448
Practice Address - Country:US
Practice Address - Phone:912-348-4420
Practice Address - Fax:912-348-4421
Is Sole Proprietor?:No
Enumeration Date:2021-01-25
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH022116183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist