Provider Demographics
NPI:1245884410
Name:KIRVEN, JOSEPH H (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:H
Last Name:KIRVEN
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 1:107 PA JOHNS RD NE APT 251
Mailing Address - Street 2:
Mailing Address - City:MILLEDGEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31061-7446
Mailing Address - Country:US
Mailing Address - Phone:843-858-0398
Mailing Address - Fax:
Practice Address - Street 1:107 PA JOHNS RD NE APT 251
Practice Address - Street 2:
Practice Address - City:MILLEDGEVILLE
Practice Address - State:GA
Practice Address - Zip Code:31061-7446
Practice Address - Country:US
Practice Address - Phone:843-858-0398
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-26
Last Update Date:2019-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA031537183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist