Provider Demographics
NPI:1861490591
Name:JOHNSON, DANNY R (R PH)
Entity Type:Individual
Prefix:MR
First Name:DANNY
Middle Name:R
Last Name:JOHNSON
Suffix:
Gender:M
Credentials:R PH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 KATLYN DR
Mailing Address - Street 2:
Mailing Address - City:SYLACAUGA
Mailing Address - State:AL
Mailing Address - Zip Code:35150-8410
Mailing Address - Country:US
Mailing Address - Phone:256-249-3047
Mailing Address - Fax:
Practice Address - Street 1:264 W FORT WILLIAMS ST
Practice Address - Street 2:
Practice Address - City:SYLACAUGA
Practice Address - State:AL
Practice Address - Zip Code:35150-2432
Practice Address - Country:US
Practice Address - Phone:256-245-4446
Practice Address - Fax:256-245-4484
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL7265183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist