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General NPI Number Information
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NPI Number | 1235409707
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Entity Type | Individual
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Provider Name | JOSEPH R JANOSTAK RPH
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Gender | Male
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Dates
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Enumeration Date | 12/30/2011
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Last Update Date | 12/30/2011
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Provider Practice Location Address
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Address Line | 9036 ORCHARD DR
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City | HIGHLAND
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State | IN
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Zip | 46322-2212
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Country | US
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Telephone | 219-923-3699
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Fax |
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Provider Business Mailing Address
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Address Line | 9036 ORCHARD DR.
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City | HIGHLAND
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State | IN
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Zip | 46322
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Country | US
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Telephone | 219-923-3699
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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 | 26011718A
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License Number State | IN
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