MEDICARE: JOSHUA ANTHONY KOROGHLI PHARM.D., M.B.A

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	18397	NV

General Provider Information

NPI Number	:	1699100495
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSHUA ANTHONY KOROGHLI PHARM.D., M.B.A

Provider Business Mailing Address
First Line	:	4225 S EASTERN AVE STE 16
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-5485
Country	:	US
Telephone Number	:	702-333-4377
Fax Number	:

Provider Business Practice Location Address
First Line	:	3808 E TROPICANA AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89121-6021
Country	:	US
Telephone Number	:	702-547-0830
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/11/2013
Last Update Date	:	11/16/2020

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