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General NPI Number Information
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NPI Number | 1174800262
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Entity Type | Individual
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Provider Name | JOSHUA OTIS JOHNSON PHARMD
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Gender | Male
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Dates
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Enumeration Date | 11/03/2011
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Last Update Date | 09/20/2016
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Provider Practice Location Address
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Address Line | 3400 YANKEE DR
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City | EAGAN
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State | MN
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Zip | 55121-1627
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Country | US
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Telephone | 651-662-7418
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Fax |
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Provider Business Mailing Address
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Address Line | 13963 BLUEBIRD ST NW
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City | ANDOVER
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State | MN
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Zip | 55304-4052
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Country | US
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Telephone | 763-331-2139
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 119471
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License Number State | MN
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