Provider Demographics
NPI:1053907758
Name:BUREMOH, JOEL (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JOEL
Middle Name:
Last Name:BUREMOH
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 1:10101 TAYLORSVILLE RD STE 102
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40299-3652
Mailing Address - Country:US
Mailing Address - Phone:502-267-7453
Mailing Address - Fax:
Practice Address - Street 1:10101 TAYLORSVILLE RD STE 102
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40299-3652
Practice Address - Country:US
Practice Address - Phone:502-267-7453
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-16
Last Update Date:2020-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY019180183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist