Provider Demographics
NPI:1265878912
Name:CARPENTER, DANIEL DEAN (RPH)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:DEAN
Last Name:CARPENTER
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 1:6 COTTONGRASS CT
Mailing Address - Street 2:
Mailing Address - City:BROWNSBURG
Mailing Address - State:IN
Mailing Address - Zip Code:46112-7882
Mailing Address - Country:US
Mailing Address - Phone:317-625-1127
Mailing Address - Fax:
Practice Address - Street 1:6 COTTONGRASS CT
Practice Address - Street 2:
Practice Address - City:BROWNSBURG
Practice Address - State:IN
Practice Address - Zip Code:46112-7882
Practice Address - Country:US
Practice Address - Phone:317-625-1127
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-21
Last Update Date:2013-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI11502-40183500000X
ARPD09032183500000X
AZ14392183500000X
MN115672183500000X
NE12076183500000X
NV15495183500000X
TN11375183500000X
TX35356183500000X
IN26021909A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist