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General NPI Number Information
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NPI Number | 1942486204
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Entity Type | Individual
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Provider Name | STACY REBECCA MCDANIEL PHARM.D
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Gender | Female
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Dates
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Enumeration Date | 01/17/2008
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Last Update Date | 05/19/2020
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Provider Practice Location Address
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Address Line | 1365 CLIFTON RD NE
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City | ATLANTA
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State | GA
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Zip | 30322-1152
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Country | US
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Telephone | 404-778-1900
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Fax |
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Provider Business Mailing Address
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Address Line | 531 ROSELANE ST NW SUITE 710
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City | MARIETTA
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State | GA
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Zip | 30060-6913
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Country | US
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Telephone | 770-281-5115
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Fax | 678-581-7111
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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 | 1835X0200X
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Taxonomy Name | Oncology Pharmacist
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License Number | RPH023190
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RPH023190
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License Number State | GA
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