Provider Demographics
NPI:1376246397
Name:COVER, DANA (RPH)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:
Last Name:COVER
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 1:925 LINDMARK DR
Mailing Address - Street 2:
Mailing Address - City:WENTZVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63385-6878
Mailing Address - Country:US
Mailing Address - Phone:573-330-4369
Mailing Address - Fax:
Practice Address - Street 1:212 HOSPITAL LN STE 102
Practice Address - Street 2:
Practice Address - City:PERRYVILLE
Practice Address - State:MO
Practice Address - Zip Code:63775-4204
Practice Address - Country:US
Practice Address - Phone:573-547-4960
Practice Address - Fax:573-547-6540
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-27
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051287027183500000X
MO2001028207183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist