Provider Demographics
NPI:1265160345
Name:KRAFT, JOSHUA RAYMOND (RPH)
Entity type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:RAYMOND
Last Name:KRAFT
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12305 MOUNT MORRIS RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIAVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48421-8808
Mailing Address - Country:US
Mailing Address - Phone:810-441-1763
Mailing Address - Fax:
Practice Address - Street 1:5018 CLIO RD
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48504-1809
Practice Address - Country:US
Practice Address - Phone:810-787-2232
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-08
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302414502183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist