Healthcare Provider Details

I. General information

NPI: 1568008845
Provider Name (Legal Business Name): JOSHUA BOKELMAN RPH.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/21/2019
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6260 W MCGALLIARD RD
MUNCIE IN
47304-9413
US

IV. Provider business mailing address

4202 W WOODS EDGE LN
MUNCIE IN
47304-6087
US

V. Phone/Fax

Practice location:
  • Phone: 765-281-7810
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number26024268A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number26024268A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: