MEDICARE: DR. DANIEL JACK MCALLISTER PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	16717	OK
2	183500000X	Pharmacist	PD14918	AR

General Provider Information

NPI Number	:	1114793437
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIEL JACK MCALLISTER PHARMD

Provider Business Mailing Address
First Line	:	MERCY PHARMACY FT. SMITH
Second Line	:	7301 ROGERS AVE
City	:	FORT SMITH
State	:	AR
Zip	:	72903
Country	:	US
Telephone Number	:	479-314-6142
Fax Number	:	479-314-6153

Provider Business Practice Location Address
First Line	:	MERCY PHARMACY FT. SMITH
Second Line	:	7301 ROGERS AVE
City	:	FORT SMITH
State	:	AR
Zip	:	72903
Country	:	US
Telephone Number	:	479-314-6142
Fax Number	:	479-314-6513

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/28/2023
Last Update Date	:	11/28/2023

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