1245765064 NPI number — DR. DANIELLE HOPE MCCLELLAND PHARMD

Table of content: DR. DANIELLE HOPE MCCLELLAND PHARMD (NPI 1245765064)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1245765064 NPI number — DR. DANIELLE HOPE MCCLELLAND PHARMD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MCCLELLAND
Provider First Name:
DANIELLE
Provider Middle Name:
HOPE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PHARMD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CARPENTER
Provider Other First Name:
DANIELLE
Provider Other Middle Name:
HOPE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
PHARMD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1245765064
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/01/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5792 MEDALLION DR W
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WESTERVILLE
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43082
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
614-805-4481
Provider Business Mailing Address Fax Number:
614-410-2009

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4241 IRWIN SIMPSON RD
Provider Second Line Business Practice Location Address:
BLDG II
Provider Business Practice Location Address City Name:
MASON
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45040
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
866-787-6341
Provider Business Practice Location Address Fax Number:
614-410-2009
Provider Enumeration Date:
04/30/2017

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  03233308 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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