Healthcare Provider Details

I. General information

NPI: 1053525949
Provider Name (Legal Business Name): DANIEL CALLAHAN RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/09/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

249 ROUTE 202
RINDGE NH
03461
US

IV. Provider business mailing address

193 S MAIN ST
TROY NH
03465-2319
US

V. Phone/Fax

Practice location:
  • Phone: 603-899-6965
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number3190
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: