Healthcare Provider Details

I. General information

NPI: 1770179384
Provider Name (Legal Business Name): JOSHUA CALEB LAWSON PHARM D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/17/2020
Last Update Date: 12/17/2020
Certification Date: 12/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1951 N CENTER ST
ELKINS AR
72727-2900
US

IV. Provider business mailing address

1951 N CENTER ST
ELKINS AR
72727-2900
US

V. Phone/Fax

Practice location:
  • Phone: 479-643-2362
  • Fax: 479-643-2368
Mailing address:
  • Phone: 479-643-2362
  • Fax: 479-643-2368

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPD14087
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: