Provider Demographics
NPI:1801180088
Name:JOLLIFF, JOSEPH MICHAEL (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:MICHAEL
Last Name:JOLLIFF
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2195 E PROSPERITY AVE
Mailing Address - Street 2:TARGET PHARMACY STORE T-2349
Mailing Address - City:TULARE
Mailing Address - State:CA
Mailing Address - Zip Code:93274-7754
Mailing Address - Country:US
Mailing Address - Phone:559-631-1129
Mailing Address - Fax:559-631-1139
Practice Address - Street 1:2195 E PROSPERITY AVE
Practice Address - Street 2:TARGET PHARMACY STORE T-2349
Practice Address - City:TULARE
Practice Address - State:CA
Practice Address - Zip Code:93274-7754
Practice Address - Country:US
Practice Address - Phone:559-631-1129
Practice Address - Fax:559-631-1139
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-05
Last Update Date:2011-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA62654183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist