Healthcare Provider Details

I. General information

NPI: 1386291136
Provider Name (Legal Business Name): JOSHUA CLEAVER PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/26/2019
Last Update Date: 10/02/2023
Certification Date: 10/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UNIT 3215 RAMSTEIN AIR BASE
APO GERMANY
09094-3215
DE

IV. Provider business mailing address

UNIT 3215 BOX 86MDG
APO AE
09094-3215
US

V. Phone/Fax

Practice location:
  • Phone: 314-479-2273
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number020970
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: