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NPI Code Detail

MEDICARE: MR. JERRY DON DANNER RPH, CDE

MEDICARE: MR. JERRY DON DANNER RPH, CDE
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
11835P1200XPharmacotherapy Pharmacist18785TX

General Provider Information

NPI Number : 1508867748
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JERRY DON DANNER RPH, CDE
Provider Business Mailing Address
First Line : 3600 TYNDALE LN
Second Line :
City : AMARILLO
State : TX
Zip : 79118-5057
Country : US
Telephone Number : 806-570-4542
Fax Number : 806-354-7857
Provider Business Practice Location Address
First Line : 6010 W AMARILLO BLVD
Second Line :
City : AMARILLO
State : TX
Zip : 79106-1990
Country : US
Telephone Number : 806-354-7898
Fax Number : 806-354-7857
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/10/2005
Last Update Date : 07/08/2007

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