Provider Demographics
NPI:1740710219
Name:POLING, JOSEPH (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:
Last Name:POLING
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 1:3780 E 15TH ST STE 102
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-8768
Mailing Address - Country:US
Mailing Address - Phone:970-461-1975
Mailing Address - Fax:970-461-4042
Practice Address - Street 1:2033 BOISE AVE
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538-5037
Practice Address - Country:US
Practice Address - Phone:970-669-7500
Practice Address - Fax:970-667-1095
Is Sole Proprietor?:No
Enumeration Date:2017-06-15
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0019580183500000X
CO195801835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist