Provider Demographics
NPI:1538165857
Name:DASTA, JOSEPH F (RPH)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:F
Last Name:DASTA
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:STEPHEN
Other - Middle Name:
Other - Last Name:JOBS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CEO
Mailing Address - Street 1:2040 FINCASTLE CT
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43235-2007
Mailing Address - Country:US
Mailing Address - Phone:614-292-6352
Mailing Address - Fax:
Practice Address - Street 1:500 W 12TH AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43210-1214
Practice Address - Country:US
Practice Address - Phone:614-292-6352
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-1-109341835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy