=====================================================
General NPI Number Information
=====================================================
NPI Number | 1043993462
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JOSHUA WEBB PHARMD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/11/2023
-----------------------------------------------------
Last Update Date | 08/11/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 341 W HIGH ST
-----------------------------------------------------
City | BRYAN
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43506-1615
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 419-636-5021
-----------------------------------------------------
Fax | 419-633-3087
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 12150 COUNTY ROAD C
-----------------------------------------------------
City | BRYAN
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43506-9534
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 419-799-2153
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 03443534
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------