Provider Demographics
NPI:1275134751
Name:TUMMEL, DANIEL (BSP, RPH)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:TUMMEL
Suffix:
Gender:M
Credentials:BSP, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4004 TUSCARAWAS ST W
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44708-5503
Mailing Address - Country:US
Mailing Address - Phone:330-479-9630
Mailing Address - Fax:330-479-9661
Practice Address - Street 1:4004 TUSCARAWAS ST W
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44708-5503
Practice Address - Country:US
Practice Address - Phone:330-479-9630
Practice Address - Fax:330-479-9661
Is Sole Proprietor?:No
Enumeration Date:2020-11-03
Last Update Date:2020-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03323958183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist