MEDICARE: DR. DANIEL NEAL PHARM.D., BCPS

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	1835P1200X	Pharmacotherapy Pharmacist	46678	CA

General Provider Information

NPI Number	:	1245273713
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIEL NEAL PHARM.D., BCPS

Provider Business Mailing Address
First Line	:	913 NW GARDEN VALLEY BLVD
Second Line	:	VA MEDICAL CENTER
City	:	ROSEBURG
State	:	OR
Zip	:	97470-6169
Country	:	US
Telephone Number	:	541-440-1311
Fax Number	:

Provider Business Practice Location Address
First Line	:	913 NW GARDEN VALLEY BLVD
Second Line	:
City	:	ROSEBURG
State	:	OR
Zip	:	97470-6523
Country	:	US
Telephone Number	:	541-440-1311
Fax Number	:

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

Provider Enumeration Date	:	06/13/2006
Last Update Date	:	07/17/2007

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