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NPI Code Detail

MEDICARE: DANIELLE FULKROD PHARM D

MEDICARE: DANIELLE FULKROD PHARM D
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
1183500000XPharmacist0202214028VA
2183500000XPharmacist39961TN
3183500000XPharmacistRP0009444WV

General Provider Information

NPI Number : 1184007882
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANIELLE FULKROD PHARM D
Provider Business Mailing Address
First Line : 103 N SHADY ST
Second Line :
City : MOUNTAIN CITY
State : TN
Zip : 37683-1333
Country : US
Telephone Number : 423-727-5651
Fax Number :
Provider Business Practice Location Address
First Line : 103 N SHADY ST
Second Line :
City : MOUNTAIN CITY
State : TN
Zip : 37683-1333
Country : US
Telephone Number : 423-727-5651
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/30/2015
Last Update Date : 04/14/2017

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Directions to “ DANIELLE FULKROD PHARM D” Practice Location

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