Healthcare Provider Details

I. General information

NPI: 1801321567
Provider Name (Legal Business Name): MR. JOSHUA MIN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/01/2017
Last Update Date: 05/22/2023
Certification Date: 05/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

880 S PERRY ST
CASTLE ROCK CO
80104-1936
US

IV. Provider business mailing address

880 S PERRY ST
CASTLE ROCK CO
80104-1936
US

V. Phone/Fax

Practice location:
  • Phone: 303-688-6060
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number75122
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0024388
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: