Provider Demographics
NPI:1730878323
Name:MADELUNG, JOSHUA (CPHT)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:
Last Name:MADELUNG
Suffix:
Gender:M
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 CEDAR LN
Mailing Address - Street 2:
Mailing Address - City:LEE
Mailing Address - State:NH
Mailing Address - Zip Code:03861-4416
Mailing Address - Country:US
Mailing Address - Phone:603-583-3220
Mailing Address - Fax:
Practice Address - Street 1:58 CALEF HWY
Practice Address - Street 2:
Practice Address - City:LEE
Practice Address - State:NH
Practice Address - Zip Code:03861-6701
Practice Address - Country:US
Practice Address - Phone:603-868-6404
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-01
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHCPHT-126963183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician