Daniel Loper, RPH, DVM
Individual provider Active NPI Pharmacist · Bogart, GA
NPI 1285988055 · NPPES record last updated Nov 1, 2012
Key facts
- NPI
- 1285988055
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 10502 (NC)
- Practice address
- 150 Cleveland Rd
Bogart, GA 30622-1701 - Phone
- (706) 369-9591
- NPI assigned
- Nov 1, 2012
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPH016265 | GA | MD | Pharmacist |
| 2009023449 | MO | MD | Pharmacist |
| 10502 | NC | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH016265 | GA | |
| Pharmacist | 183500000X | 2009023449 | MO | |
| Pharmacist | 183500000X | 10502 | NC | Yes |
Addresses
Primary practice location
150 Cleveland Rd
Bogart, GA 30622-1701
Mailing address
150 Cleveland Rd
Bogart, GA 30622-1701
Phone (706) 369-9591
Other providers in Bogart, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 1, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.