Provider Demographics
NPI:1497368237
Name:MCDANIEL, LAUREN HELENA (PHARMD)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:HELENA
Last Name:MCDANIEL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 SANSOM ST APT 9D
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19103-5103
Mailing Address - Country:US
Mailing Address - Phone:570-793-1841
Mailing Address - Fax:
Practice Address - Street 1:10 SNYDER AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19148-2700
Practice Address - Country:US
Practice Address - Phone:215-465-3270
Practice Address - Fax:215-465-7645
Is Sole Proprietor?:No
Enumeration Date:2020-08-30
Last Update Date:2020-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP454741183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist