Provider Demographics
NPI:1013747757
Name:CHILDERS, JOSHUA CALEB (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:CALEB
Last Name:CHILDERS
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 1:642 LANHAM RD
Mailing Address - Street 2:
Mailing Address - City:EDGEFIELD
Mailing Address - State:SC
Mailing Address - Zip Code:29824-3808
Mailing Address - Country:US
Mailing Address - Phone:803-275-7508
Mailing Address - Fax:
Practice Address - Street 1:1284 KNOX AVE
Practice Address - Street 2:
Practice Address - City:NORTH AUGUSTA
Practice Address - State:SC
Practice Address - Zip Code:29841-4055
Practice Address - Country:US
Practice Address - Phone:803-442-4510
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-06
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC60278183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist