Healthcare Provider Details

I. General information

NPI: 1346228236
Provider Name (Legal Business Name): DANIEL J MCCOY RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/03/2006
Last Update Date: 08/17/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

708 EKASTOWN RD
SARVER PA
16055-9724
US

IV. Provider business mailing address

127 CRESCENT HILL DR
SARVER PA
16055-9704
US

V. Phone/Fax

Practice location:
  • Phone: 724-353-1420
  • Fax:
Mailing address:
  • Phone: 724-353-0153
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP045384R
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: