Provider Demographics
NPI:1699380113
Name:HARRISON, DANIEL JR (DOCTOR OF PHARMACY)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:
Last Name:HARRISON
Suffix:JR
Gender:M
Credentials:DOCTOR OF PHARMACY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1917 LONG RDG
Mailing Address - Street 2:
Mailing Address - City:ELKVIEW
Mailing Address - State:WV
Mailing Address - Zip Code:25071-9024
Mailing Address - Country:US
Mailing Address - Phone:304-373-6727
Mailing Address - Fax:
Practice Address - Street 1:221 CROSSINGS MALL RD
Practice Address - Street 2:
Practice Address - City:ELKVIEW
Practice Address - State:WV
Practice Address - Zip Code:25071-9230
Practice Address - Country:US
Practice Address - Phone:304-965-0460
Practice Address - Fax:304-965-6055
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-11
Last Update Date:2020-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0007486183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist