Provider Demographics
NPI:1750384483
Name:LONGYHORE, DANIEL S (PHARMD, EDD)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:S
Last Name:LONGYHORE
Suffix:
Gender:M
Credentials:PHARMD, EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 111; WILKES UNIVERSITY
Mailing Address - Street 2:
Mailing Address - City:WILKES BARRE
Mailing Address - State:PA
Mailing Address - Zip Code:18766-0001
Mailing Address - Country:US
Mailing Address - Phone:570-408-4294
Mailing Address - Fax:570-408-7729
Practice Address - Street 1:100 N ACADEMY AVE # MC24-06
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:PA
Practice Address - Zip Code:17822-9800
Practice Address - Country:US
Practice Address - Phone:570-214-1737
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-05-27
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP4378531835P1200X
SC0105751835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy