Provider Demographics
NPI:1770925117
Name:LASTOVICA, JOSEPH (PHARM D)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:LASTOVICA
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 1:4093 DAVIS DR
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-8805
Mailing Address - Country:US
Mailing Address - Phone:919-380-3385
Mailing Address - Fax:
Practice Address - Street 1:4093 DAVIS DR
Practice Address - Street 2:
Practice Address - City:MORRISVILLE
Practice Address - State:NC
Practice Address - Zip Code:27560-8805
Practice Address - Country:US
Practice Address - Phone:919-380-3385
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-26
Last Update Date:2013-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC19472183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist