Provider Demographics
NPI:1275615031
Name:HELLER, DANIEL B (RPH)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:B
Last Name:HELLER
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 1:255 S 17TH ST
Mailing Address - Street 2:MEDICAL TOWER PHARMACY
Mailing Address - City:PHILA
Mailing Address - State:PA
Mailing Address - Zip Code:19103-6231
Mailing Address - Country:US
Mailing Address - Phone:215-545-3525
Mailing Address - Fax:215-732-7013
Practice Address - Street 1:255 S 17TH ST
Practice Address - Street 2:MEDICAL TOWER PHARMACY
Practice Address - City:PHILA
Practice Address - State:PA
Practice Address - Zip Code:19103-6231
Practice Address - Country:US
Practice Address - Phone:215-545-3525
Practice Address - Fax:215-732-7013
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2008-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP039848L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PARP039848LOtherPHARMACIST