Healthcare Provider Details

I. General information

NPI: 1467510735
Provider Name (Legal Business Name): DANIEL EDWARD KINNAIRD PHARMACIST
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/05/2006
Last Update Date: 09/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

LANDSTUHL REGIONAL MEDICAL CENTER CMR 402
APO AE
09180
US

IV. Provider business mailing address

LANDSTUHL REGIONAL MEDICAL CENTER CMR 402
APO AE
09180
US

V. Phone/Fax

Practice location:
  • Phone: 496371866456
  • Fax: 496371868267
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835G0303X
TaxonomyGeriatric Pharmacist
License Number0202004471
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: