Provider Demographics
NPI:1164690053
Name:PITCHFORD, DANIEL WILLIAM (RPH)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:WILLIAM
Last Name:PITCHFORD
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:412 SPRUCE CIR
Mailing Address - Street 2:
Mailing Address - City:EXTON
Mailing Address - State:PA
Mailing Address - Zip Code:19341-2018
Mailing Address - Country:US
Mailing Address - Phone:610-594-7019
Mailing Address - Fax:610-594-7019
Practice Address - Street 1:3400 SPRUCE ST
Practice Address - Street 2:RAVDIN 1
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-4206
Practice Address - Country:US
Practice Address - Phone:215-662-2920
Practice Address - Fax:215-349-8340
Is Sole Proprietor?:No
Enumeration Date:2008-02-14
Last Update Date:2008-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP032471L183500000X
OK11302183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK11302OtherRPH STATE LICENSE NUMBER
PARP032471LOtherRPH STATE LICENSE NUMBER