Provider Demographics
NPI:1639502503
Name:GROTH, DANIELLE KRISTEN (PHARMD, RPH)
Entity Type:Individual
Prefix:DR
First Name:DANIELLE
Middle Name:KRISTEN
Last Name:GROTH
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 W DEKALB PIKE
Mailing Address - Street 2:
Mailing Address - City:KING OF PRUSSIA
Mailing Address - State:PA
Mailing Address - Zip Code:19406-2303
Mailing Address - Country:US
Mailing Address - Phone:610-768-4105
Mailing Address - Fax:610-768-4109
Practice Address - Street 1:320 W DEKALB PIKE
Practice Address - Street 2:
Practice Address - City:KING OF PRUSSIA
Practice Address - State:PA
Practice Address - Zip Code:19406-2303
Practice Address - Country:US
Practice Address - Phone:610-768-4105
Practice Address - Fax:610-768-4109
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-15
Last Update Date:2013-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP447800183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist