MEDICARE: DR. JOSHUA BORER PHARMD

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	12330	NE
2	183500000X	Pharmacist	21536	IA

General Provider Information

NPI Number	:	1811489677
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSHUA BORER PHARMD

Provider Business Mailing Address
First Line	:	1607 E 7TH ST
Second Line	:
City	:	ATLANTIC
State	:	IA
Zip	:	50022-1910
Country	:	US
Telephone Number	:	712-243-2110
Fax Number	:

Provider Business Practice Location Address
First Line	:	1607 E 7TH ST
Second Line	:
City	:	ATLANTIC
State	:	IA
Zip	:	50022-1910
Country	:	US
Telephone Number	:	712-243-2110
Fax Number	:

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

Provider Enumeration Date	:	06/06/2018
Last Update Date	:	03/06/2020

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