MEDICARE: DANIEL S LONGYHORE PHARM.D., ED.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
1	1835P1200X	Pharmacotherapy Pharmacist	RP437853	PA

General Provider Information

NPI Number	:	1750384483
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIEL S LONGYHORE PHARM.D., ED.D.

Provider Business Mailing Address
First Line	:	PO BOX 111; WILKES UNIVERSITY
Second Line	:
City	:	WILKES BARRE
State	:	PA
Zip	:	18766-0001
Country	:	US
Telephone Number	:	570-408-4294
Fax Number	:	570-408-7729

Provider Business Practice Location Address
First Line	:	100 N ACADEMY AVE # MC24-06
Second Line	:
City	:	DANVILLE
State	:	PA
Zip	:	17822-9800
Country	:	US
Telephone Number	:	570-214-1737
Fax Number	:

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

Provider Enumeration Date	:	05/27/2005
Last Update Date	:	02/21/2024

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