Provider Demographics
NPI:1558344713
Name:DOLIN, DANI S (RPH, PHARMD, CDE)
Entity Type:Individual
Prefix:DR
First Name:DANI
Middle Name:S
Last Name:DOLIN
Suffix:
Gender:F
Credentials:RPH, PHARMD, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:710 GENESIS BLVD
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:WV
Mailing Address - Zip Code:26330-9668
Mailing Address - Country:US
Mailing Address - Phone:681-342-3070
Mailing Address - Fax:304-808-6085
Practice Address - Street 1:177 MIDDLETOWN RD STE 2
Practice Address - Street 2:
Practice Address - City:FAIRMONT
Practice Address - State:WV
Practice Address - Zip Code:26554-8254
Practice Address - Country:US
Practice Address - Phone:304-368-9355
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-22
Last Update Date:2020-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0006557183500000X
WV65571835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist