Provider Demographics
NPI:1750421327
Name:DAVIS, JOSHUA WAYNE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:WAYNE
Last Name:DAVIS
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 1:11895 400TH ST
Mailing Address - Street 2:
Mailing Address - City:MELROSE
Mailing Address - State:IA
Mailing Address - Zip Code:52569-7701
Mailing Address - Country:US
Mailing Address - Phone:641-203-1428
Mailing Address - Fax:
Practice Address - Street 1:510 E JEFFERSON ST STE A
Practice Address - Street 2:
Practice Address - City:CORYDON
Practice Address - State:IA
Practice Address - Zip Code:50060-1812
Practice Address - Country:US
Practice Address - Phone:641-872-2030
Practice Address - Fax:641-872-2031
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2020-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA20344183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist