Healthcare Provider Details

I. General information

NPI: 1124658190
Provider Name (Legal Business Name): JOSHUA HARTSELL PHARM D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/18/2020
Last Update Date: 05/23/2026
Certification Date: 05/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

48 BULLSBORO DR
NEWNAN GA
30263-1461
US

IV. Provider business mailing address

1355 S PARK ST
CARROLLTON GA
30117-4433
US

V. Phone/Fax

Practice location:
  • Phone: 770-251-5188
  • Fax:
Mailing address:
  • Phone: 770-832-9015
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number027185
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number19022
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: