Provider Demographics
NPI:1942076005
Name:BLAIN, JOSHUA WILLIAM (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:WILLIAM
Last Name:BLAIN
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 1:601 N HAWTHORNE DR
Mailing Address - Street 2:
Mailing Address - City:MUNCIE
Mailing Address - State:IN
Mailing Address - Zip Code:47304-3508
Mailing Address - Country:US
Mailing Address - Phone:217-851-7186
Mailing Address - Fax:
Practice Address - Street 1:4801 W CLARA LN
Practice Address - Street 2:
Practice Address - City:MUNCIE
Practice Address - State:IN
Practice Address - Zip Code:47304-5548
Practice Address - Country:US
Practice Address - Phone:765-284-7181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-30
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26029416A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist