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NPI Code Detail

MEDICARE: JOSHUA-JAMES BALLNIK PHARMD

MEDICARE: JOSHUA-JAMES BALLNIK PHARMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist5302040810MI

General Provider Information

NPI Number : 1821463290
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSHUA-JAMES BALLNIK PHARMD
Provider Business Mailing Address
First Line : 1755 N DENWOOD ST
Second Line :
City : DEARBORN
State : MI
Zip : 48128-1124
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 32201 HARPER AVE
Second Line :
City : SAINT CLAIR SHORES
State : MI
Zip : 48082-1408
Country : US
Telephone Number : 586-293-5152
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/09/2015
Last Update Date : 12/09/2015

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