Provider Demographics
NPI:1063287472
Name:MCCARVILLE, DANIEL J (PHARMD)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:J
Last Name:MCCARVILLE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2623 S TIMBER PINE LN
Mailing Address - Street 2:
Mailing Address - City:PINETOP LAKESIDE
Mailing Address - State:AZ
Mailing Address - Zip Code:85935-7110
Mailing Address - Country:US
Mailing Address - Phone:651-558-1767
Mailing Address - Fax:
Practice Address - Street 1:200 W HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:WHITERIVER
Practice Address - State:AZ
Practice Address - Zip Code:85941
Practice Address - Country:US
Practice Address - Phone:928-338-5500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-16
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS023108183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist