Provider Demographics
NPI:1770867624
Name:HARPER, DAN LOREN (RPH)
Entity Type:Individual
Prefix:MR
First Name:DAN
Middle Name:LOREN
Last Name:HARPER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1539 NE STEPHENS ST
Mailing Address - Street 2:
Mailing Address - City:ROSEBURG
Mailing Address - State:OR
Mailing Address - Zip Code:97470-1563
Mailing Address - Country:US
Mailing Address - Phone:541-673-1526
Mailing Address - Fax:
Practice Address - Street 1:1539 NE STEPHENS ST
Practice Address - Street 2:
Practice Address - City:ROSEBURG
Practice Address - State:OR
Practice Address - Zip Code:97470-1563
Practice Address - Country:US
Practice Address - Phone:541-673-1526
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-10
Last Update Date:2011-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR8046183500000X
AZS05462183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist