Provider Demographics
NPI:1457992133
Name:STAPLETON, DANIEL JAMES (PHARMD)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:JAMES
Last Name:STAPLETON
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 1:45 S STATE ST
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84058-5417
Mailing Address - Country:US
Mailing Address - Phone:801-224-3332
Mailing Address - Fax:
Practice Address - Street 1:45 S STATE ST
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84058-5417
Practice Address - Country:US
Practice Address - Phone:801-224-3332
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-03
Last Update Date:2019-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6531316-1701183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist