Organization
TERRY R DANIELS
Active
Other names
Warren Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TERRY R DANIELS PD MDIV (OWNER PHARMACIST SECRETARY JANITOR)
(260) 375-2135
Entity
Organization
Contact information
Practice address
222 N WAYNE ST, WARREN, IN 46792-0345
(260) 375-2135
Mailing address
PO BOX 345, WARREN, IN 46792-0345
(260) 375-2135
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
60004799A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200022820
—
IN
05
—
200022820A
—
IN
Enumeration date
03/06/2007
Last updated
01/05/2009
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