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General NPI Number Information
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NPI Number | 1790127181
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Entity Type | Individual
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Provider Name | DANIEL ADAM PELLETIER PHARMD
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Gender | Male
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Dates
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Enumeration Date | 07/25/2013
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Last Update Date | 07/25/2013
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Provider Practice Location Address
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Address Line | 55 E RAY RD
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City | CHANDLER
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State | AZ
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Zip | 85225-3337
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Country | US
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Telephone | 480-782-7773
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Fax |
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Provider Business Mailing Address
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Address Line | 2255 W GERMANN RD #1150
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City | CHANDLER
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State | AZ
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Zip | 85286-7101
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Country | US
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Telephone | 563-940-0792
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Fax |
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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 | S019941
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License Number State | AZ
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