MEDICARE: DR. DANIEL MEYER 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
1	183500000X	Pharmacist	26027195A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	26027195A	OTHER	IN	PHARMACIST LICENSE NUMBER

General Provider Information

NPI Number	:	1629591029
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIEL MEYER PHARMD

Provider Business Mailing Address
First Line	:	6939 W BROADWAY
Second Line	:
City	:	MCCORDSVILLE
State	:	IN
Zip	:	46055-9008
Country	:	US
Telephone Number	:	317-510-0310
Fax Number	:

Provider Business Practice Location Address
First Line	:	6939 W BROADWAY
Second Line	:
City	:	MCCORDSVILLE
State	:	IN
Zip	:	46055-9008
Country	:	US
Telephone Number	:	317-510-0310
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/18/2017
Last Update Date	:	07/18/2017

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