Provider Demographics
NPI:1750264594
Name:ROSARIO NEGRON, JOSHUA CALEB
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:CALEB
Last Name:ROSARIO NEGRON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2072 E ALMADALE CT
Mailing Address - Street 2:APT 101
Mailing Address - City:COLLIERVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38017
Mailing Address - Country:US
Mailing Address - Phone:901-721-7602
Mailing Address - Fax:
Practice Address - Street 1:7950 CRAFT GOODMAN FRONTAGE RD
Practice Address - Street 2:
Practice Address - City:OLIVE BRANCH
Practice Address - State:MS
Practice Address - Zip Code:38654
Practice Address - Country:US
Practice Address - Phone:662-890-5868
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-29
Last Update Date:2025-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS102030183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist