Provider Demographics
NPI:1417392184
Name:PRICE, DARYL MICHAEL DAVID (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:DARYL MICHAEL
Middle Name:DAVID
Last Name:PRICE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 N ELM AVE
Mailing Address - Street 2:
Mailing Address - City:ERWIN
Mailing Address - State:TN
Mailing Address - Zip Code:37650-1417
Mailing Address - Country:US
Mailing Address - Phone:423-767-3853
Mailing Address - Fax:
Practice Address - Street 1:401 N MAIN AVE
Practice Address - Street 2:
Practice Address - City:ERWIN
Practice Address - State:TN
Practice Address - Zip Code:37650-1207
Practice Address - Country:US
Practice Address - Phone:423-767-3853
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-07
Last Update Date:2013-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN36732183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist