Provider Demographics
NPI:1598184160
Name:MCDANIEL, ANNA (PHARMD)
Entity Type:Individual
Prefix:MISS
First Name:ANNA
Middle Name:
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 1:360 HARBISON BLVD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29212-2248
Mailing Address - Country:US
Mailing Address - Phone:803-732-0617
Mailing Address - Fax:803-732-3172
Practice Address - Street 1:360 HARBISON BLVD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29212-2248
Practice Address - Country:US
Practice Address - Phone:803-732-0617
Practice Address - Fax:803-732-3172
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-10
Last Update Date:2014-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC13341183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist