Healthcare Provider Details

I. General information

NPI: 1366724593
Provider Name (Legal Business Name): DANIEL JAMES URBAN PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2011
Last Update Date: 09/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3625 S COLLEGE RD
WILMINGTON NC
28412-2003
US

IV. Provider business mailing address

3625 S COLLEGE RD
WILMINGTON NC
28412-2003
US

V. Phone/Fax

Practice location:
  • Phone: 910-395-8248
  • Fax:
Mailing address:
  • Phone: 910-395-8248
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number19917
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: