Healthcare Provider Details

I. General information

NPI: 1134867237
Provider Name (Legal Business Name): JOSHUA PRYOR PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2022
Last Update Date: 05/26/2022
Certification Date: 05/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3710 FRANKLIN BLVD
SACRAMENTO CA
95820-1128
US

IV. Provider business mailing address

3224 TORRANCE AVE
SACRAMENTO CA
95822-5534
US

V. Phone/Fax

Practice location:
  • Phone: 916-739-1071
  • Fax:
Mailing address:
  • Phone: 925-848-9231
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number84714
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: