Healthcare Provider Details

I. General information

NPI: 1689348948
Provider Name (Legal Business Name): JOSHUA DALE OLIVER PHARMD, BCOP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2021
Last Update Date: 08/02/2021
Certification Date: 08/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

619 19TH ST S # JT1735
BIRMINGHAM AL
35233-1900
US

IV. Provider business mailing address

619 19TH ST S # JT1735
BIRMINGHAM AL
35233-1900
US

V. Phone/Fax

Practice location:
  • Phone: 205-996-2887
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835X0200X
TaxonomyOncology Pharmacist
License Number17811
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: