DANIEL R FULLER JR. (NPI# 1114479102) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114479102 |
| Entity Type | Individual |
| Full Name | DANIEL R FULLER JR. |
| Credential | PHARMD |
| Practice Address |
7500 Univsersity Blvd. Moon Township PA 15108 |
| Practice Telephone | 4128930143 |
| Mailing Telephone | 4128930143 |
| Enumeration Date | 2016-10-26 |
| Last Update Date | 2016-10-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 183500000X | Pharmacist | RPI009891 | PA | Pharmacy Service Providers |
| Y | 183500000X | Pharmacist | RP449801 | PA | Pharmacy Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | PENNSYLVANIA BOARD OF PHARMACY | RP449801 | 01 |
| PA | PENNSYLVANIA BOARD OF PHARMACY | RPI009891 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629404264 | Daniel Boston Fuller | Nurse Practitioner | 340 Compaz Rd, Chesapeake, VA 23321-1602 | 2013-09-14 |
| 1174618284 | Daniel W Fuller | Dentist | 3323 Unicorn Lake Blvd # 131, Denton, TX 76210-0102 | 2006-10-04 |
| 1124681747 | Daniel Winston Fuller | Student in an Organized Health Care Education/Training Program | 7907 Ostrow St Ste F, San Diego, CA 92111-3635 | 2019-04-18 |
| 1770957094 | Daniel Everett Fuller | Nurse Anesthetist, Certified Registered | 1425 S Main St, Walnut Creek, CA 94596-5318 | 2015-11-24 |
| 1750586509 | Daniel W Fuller | Specialist | 3414 Golden Rd, Tyler, TX 75701-8336 | 2007-06-20 |
| 1023087632 | Daniel Gunn Fuller | Optometrist | 1225 Madison Ave, Memphis, TN 38104-2211 | 2006-03-16 |
| 1134126568 | Daniel G Fuller | Pediatrics | 26250 Euclid Ave, Suite 611, Euclid, OH 44132-3305 | 2005-06-30 |
| Street Address |
7500 UNIVSERSITY BLVD. |
| City | MOON TOWNSHIP |
| State | PA |
| Zip Code | 15108 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215550082 | Erin Larue | Counselor | 1010 Brodhead Rd., 2nd Floor, Moon Township, PA 15108 | 2020-05-27 |
| 1457986721 | Favored Wellness Counseling and Consulting, LLC | Counselor | 1010 Broadhead Road, 2nd Floor, Moon Township, PA 15108 | 2020-03-07 |
| 1023597937 | Jessica Marie Neff | Pharmacist | 217 Beagle Drive, Moon Township, PA 15108 | 2018-08-10 |
| 1992281125 | Aurora Recovery Services, LLC | Family Medicine | 993 Brodhead Rd Ste 201, Moon Twp, PA 15108 | 2018-07-11 |
| 1134611916 | Michaela Marie Stubna | Occupational Therapy Assistant | 54 Long Valley, Coraopolis, PA 15108 | 2018-06-06 |
| 1063924520 | Tammy Lynne Rink | Counselor | 1555 Brodhead Rd, Moon Township, PA 15108 | 2017-10-24 |
| 1194243584 | Anthony Joseph Decarlo | Specialist/Technologist | 48 Laurel Ridge Rd, Coraopolis, PA 15108 | 2017-09-06 |
| 1043768823 | Kelsey Kelleher | Physical Therapist | 100 Corporate Center Dr Ste 115, Coraopolis, PA 15108 | 2016-09-21 |
| 1518325208 | Elizabeth Thomeier Dornetto | Counselor | 993 Brodhead Rd Ste 203, Coraopolis, PA 15108 | 2016-02-09 |
| 1962818765 | Kelly Erin Corr | Counselor | 8 Hattman Dr Fl 2, Coraopolis, PA 15108 | 2014-07-01 |
| Find all providers in zip 15108 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023597937 | Jessica Marie Neff | Pharmacist | 217 Beagle Drive, Moon Township, PA 15108 | 2018-08-10 |
| 1497054555 | Susan Marie Mamula | Pharmacist | 333 Rouser Rd, Building 4, Suite 503, Moon Township, PA 15108-2773 | 2011-03-15 |
| 1376866814 | Kimberly Ann Padezanin | Pharmacist | 2000 Market Place Blvd, Moon Township, PA 15108-9737 | 2010-03-11 |
| 1013901057 | Bruce William Dadey | Pharmacist | 825 Beaver Grade Rd, Moon Township, PA 15108-2639 | 2005-09-06 |
| 1932711108 | Tyler Balsam | Pharmacist | 6906 University Blvd, Moon Township, PA 15108-4248 | 2020-08-19 |
| 1720608862 | Jason Bartolowits | Pharmacist | 5990 University Blvd, Moon Township, PA 15108-4229 | 2020-04-18 |
| 1174177802 | Louis Comis | Pharmacist | 935 Beaver Grade Rd, Moon Township, PA 15108-2747 | 2019-07-31 |
| 1477966430 | Julie Marie Styche | Pharmacist | 5990 University Blvd, Suite #30, Moon Township, PA 15108-4229 | 2014-06-08 |
| 1598005381 | Lorena Brandl | Pharmacist | 333 Rouser Rd, Moon Township, PA 15108-2773 | 2013-02-15 |
| 1093054876 | Natalie Ann Teaff | Pharmacist | 333 Rouser Rd, Buiding 4 Suite 503, Moon Township, PA 15108-2773 | 2013-02-13 |
| Find all providers in MOON TOWNSHIP | ||||
| City | MOON TOWNSHIP |
| Zip Code | 15108 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.