Provider Demographics
NPI:1245547793
Name:HARRISON, JOSHUA ALAN (PHARM D)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:ALAN
Last Name:HARRISON
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:372 TELFORD NEW VICTORY RD
Mailing Address - Street 2:
Mailing Address - City:TELFORD
Mailing Address - State:TN
Mailing Address - Zip Code:37690-2804
Mailing Address - Country:US
Mailing Address - Phone:423-913-3863
Mailing Address - Fax:
Practice Address - Street 1:372 TELFORD NEW VICTORY RD
Practice Address - Street 2:
Practice Address - City:TELFORD
Practice Address - State:TN
Practice Address - Zip Code:37690-2804
Practice Address - Country:US
Practice Address - Phone:423-913-3863
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-03
Last Update Date:2010-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC21262183500000X
TN34612183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist