Provider Demographics
NPI:1972223584
Name:HARRISON, JOSHUA SETH (PHARMACIST)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:SETH
Last Name:HARRISON
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:309 CLEVELAND ST
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:GA
Mailing Address - Zip Code:31647-7437
Mailing Address - Country:US
Mailing Address - Phone:229-507-2144
Mailing Address - Fax:
Practice Address - Street 1:378 VETERANS PKWY N
Practice Address - Street 2:
Practice Address - City:MOULTRIE
Practice Address - State:GA
Practice Address - Zip Code:31788-4171
Practice Address - Country:US
Practice Address - Phone:229-217-4812
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-01
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS64664183500000X
GARPH033799183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist