Provider Demographics
NPI:1871157305
Name:PARKER, DANIELLE ROSE (PHARMD)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:ROSE
Last Name:PARKER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4747 S PHILLIPS RD
Mailing Address - Street 2:
Mailing Address - City:HARROD
Mailing Address - State:OH
Mailing Address - Zip Code:45850-9707
Mailing Address - Country:US
Mailing Address - Phone:567-712-5232
Mailing Address - Fax:
Practice Address - Street 1:101B E PIKE ST
Practice Address - Street 2:
Practice Address - City:JACKSON CENTER
Practice Address - State:OH
Practice Address - Zip Code:45334-6000
Practice Address - Country:US
Practice Address - Phone:937-596-8100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-30
Last Update Date:2019-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03233928183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist