Provider Demographics
NPI:1184390007
Name:JOHNSTON, JOSEPH MICHAEL (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:MICHAEL
Last Name:JOHNSTON
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 1:2300 BLUFF OAK WAY APT 8205
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32311-6137
Mailing Address - Country:US
Mailing Address - Phone:719-440-2013
Mailing Address - Fax:
Practice Address - Street 1:501 CAPITAL CIR NE
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32301-3558
Practice Address - Country:US
Practice Address - Phone:859-878-2173
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-19
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX67518183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist