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NPI Code Detail

MEDICARE: DR. CASEY ANDREW DANIELS PHARMD

MEDICARE: DR. CASEY ANDREW DANIELS PHARMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist0202219137VA
2183500000XPharmacistRP0012321WV

General Provider Information

NPI Number : 1407454754
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CASEY ANDREW DANIELS PHARMD
Provider Business Mailing Address
First Line : 220 ROUND HILL RD
Second Line :
City : MARTINSVILLE
State : VA
Zip : 24112-6507
Country : US
Telephone Number : 276-632-2129
Fax Number :
Provider Business Practice Location Address
First Line : 103 COMMONWEALTH BLVD W
Second Line :
City : MARTINSVILLE
State : VA
Zip : 24112-1806
Country : US
Telephone Number : 276-632-6457
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/09/2020
Last Update Date : 10/09/2020

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