Provider Demographics
NPI:1871966895
Name:JOSEPH, PATRICK (RPH)
Entity type:Individual
Prefix:
First Name:PATRICK
Middle Name:
Last Name:JOSEPH
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:657 PHOENIX DR
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-7318
Mailing Address - Country:US
Mailing Address - Phone:757-498-3720
Mailing Address - Fax:757-498-7381
Practice Address - Street 1:657 PHOENIX DR
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-7318
Practice Address - Country:US
Practice Address - Phone:757-498-3720
Practice Address - Fax:757-498-7381
Is Sole Proprietor?:No
Enumeration Date:2015-11-13
Last Update Date:2015-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202207857183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist