Organization
MCDANIEL PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TRENTON SAMUEL MCDANIEL PHARM D (PHARMACIST)
(478) 934-6885
Entity
Organization
Contact information
Practice address
195 E DYKES ST, COCHRAN, GA 31014-6514
(478) 934-6885
(478) 934-7312
Mailing address
195 E DYKES ST, COCHRAN, GA 31014-6514
(478) 934-6885
(478) 934-7312
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
PHRE006862
GA
3336C0003X
Community/Retail Pharmacy
Primary
PHRE006862
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00356496A
—
GA
05
—
00356496B
—
GA
Enumeration date
04/19/2007
Last updated
10/20/2014
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