Provider Demographics
NPI:1801490347
Name:LAMB, DANIEL WAYNE (PHARMD)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:WAYNE
Last Name:LAMB
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 NE HIDDEN RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64064-1277
Mailing Address - Country:US
Mailing Address - Phone:816-509-7630
Mailing Address - Fax:
Practice Address - Street 1:5310 BLUE RIDGE BLVD
Practice Address - Street 2:
Practice Address - City:RAYTOWN
Practice Address - State:MO
Practice Address - Zip Code:64133-3063
Practice Address - Country:US
Practice Address - Phone:816-313-1280
Practice Address - Fax:816-313-1722
Is Sole Proprietor?:No
Enumeration Date:2020-11-25
Last Update Date:2020-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2012026454183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist