Provider Demographics
NPI:1205432366
Name:ROSEFELT, JOSHUA A (PHARMD)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:A
Last Name:ROSEFELT
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 1:1729 MARKET BLVD
Mailing Address - Street 2:
Mailing Address - City:HASTINGS
Mailing Address - State:MN
Mailing Address - Zip Code:55033-1254
Mailing Address - Country:US
Mailing Address - Phone:651-438-2135
Mailing Address - Fax:651-438-3945
Practice Address - Street 1:1729 MARKET BLVD
Practice Address - Street 2:
Practice Address - City:HASTINGS
Practice Address - State:MN
Practice Address - Zip Code:55033-1254
Practice Address - Country:US
Practice Address - Phone:651-438-2135
Practice Address - Fax:651-438-3945
Is Sole Proprietor?:No
Enumeration Date:2020-12-04
Last Update Date:2020-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN117745183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist