Provider Demographics
NPI:1689980609
Name:VOGT, JOSHUA (PHARMD, RPH)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:
Last Name:VOGT
Suffix:
Gender:M
Credentials:PHARMD, RPH
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 1019
Mailing Address - Street 2:
Mailing Address - City:FRASER
Mailing Address - State:CO
Mailing Address - Zip Code:80442-1019
Mailing Address - Country:US
Mailing Address - Phone:585-705-7284
Mailing Address - Fax:
Practice Address - Street 1:40 COUNTY RD. 804
Practice Address - Street 2:
Practice Address - City:FRASER
Practice Address - State:CO
Practice Address - Zip Code:80442
Practice Address - Country:US
Practice Address - Phone:970-726-6920
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-27
Last Update Date:2010-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO18740183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist