Provider Demographics
NPI:1083745749
Name:PALMER, DARREN JAMES (RPH MBA)
Entity Type:Individual
Prefix:MR
First Name:DARREN
Middle Name:JAMES
Last Name:PALMER
Suffix:
Gender:M
Credentials:RPH MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2790 LOWER LAKE RD
Mailing Address - Street 2:
Mailing Address - City:SENECA FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:13148-9429
Mailing Address - Country:US
Mailing Address - Phone:315-712-4033
Mailing Address - Fax:607-387-7045
Practice Address - Street 1:2083 RT 96
Practice Address - Street 2:
Practice Address - City:TRUMANSBURG
Practice Address - State:NY
Practice Address - Zip Code:14886
Practice Address - Country:US
Practice Address - Phone:607-387-6728
Practice Address - Fax:607-387-7045
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY047063183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist