Provider Demographics
NPI:1194718338
Name:SKIPPER, DANNY BRUCE (RPH)
Entity type:Individual
Prefix:MR
First Name:DANNY
Middle Name:BRUCE
Last Name:SKIPPER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:280 COUNTY ROAD 1335
Mailing Address - Street 2:
Mailing Address - City:VINEMONT
Mailing Address - State:AL
Mailing Address - Zip Code:35179-6740
Mailing Address - Country:US
Mailing Address - Phone:256-734-1376
Mailing Address - Fax:
Practice Address - Street 1:2019 6TH AVE SE
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35601-6500
Practice Address - Country:US
Practice Address - Phone:256-353-6303
Practice Address - Fax:256-355-5562
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL10115183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist