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General NPI Number Information
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NPI Number | 1770087553
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Entity Type | Individual
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Provider Name | DANNY EUAL AUSTIN DOCTOR OF PHARMACY
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Gender | Male
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Dates
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Enumeration Date | 03/19/2018
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Last Update Date | 03/19/2018
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Provider Practice Location Address
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Address Line | 1017 MULBERRY AVE
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City | SELMER
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State | TN
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Zip | 38375-3274
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Country | US
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Telephone | 731-645-3207
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Fax | 731-645-8943
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Provider Business Mailing Address
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Address Line | 1789 NEW HOPE RD
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City | GUYS
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State | TN
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Zip | 38339-5131
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Country | US
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Telephone | 731-645-3207
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Fax | 731-645-8943
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 4332
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License Number State | TN
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