Individual
DANIEL R FULLER JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
7500 UNIVSERSITY BLVD., MOON TOWNSHIP, PA 15108
(412) 893-0143
Mailing address
7500 UNIVSERSITY BLVD., MOON TOWNSHIP, PA 15108
(412) 893-0143
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP449801
PA
183500000X
Pharmacist
RPI009891
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RP449801
PENNSYLVANIA BOARD OF PHARMACY
PA
01
—
RPI009891
PENNSYLVANIA BOARD OF PHARMACY
PA
Enumeration date
10/26/2016
Last updated
10/26/2016
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