MEDICARE: DANNA LYNN MCDANIEL RPH

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	14901	NC

General Provider Information

NPI Number	:	1265765952
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANNA LYNN MCDANIEL RPH

Provider Business Mailing Address
First Line	:	190 RATTLESNAKE ST
Second Line	:
City	:	SALISBURY
State	:	NC
Zip	:	28146-8768
Country	:	US
Telephone Number	:	704-223-1450
Fax Number	:

Provider Business Practice Location Address
First Line	:	1505 E INNES ST
Second Line	:
City	:	SALISBURY
State	:	NC
Zip	:	28146-6018
Country	:	US
Telephone Number	:	704-637-6864
Fax Number	:	704-637-6807

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

Provider Enumeration Date	:	09/11/2009
Last Update Date	:	09/11/2009

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