Provider Demographics
NPI:1912598616
Name:CUSSINS, DANIEL RAY (RPH)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:RAY
Last Name:CUSSINS
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:PO BOX 457
Mailing Address - Street 2:
Mailing Address - City:SHEFFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:16347-0457
Mailing Address - Country:US
Mailing Address - Phone:814-968-3636
Mailing Address - Fax:814-968-3959
Practice Address - Street 1:27 S MAIN ST
Practice Address - Street 2:
Practice Address - City:SHEFFIELD
Practice Address - State:PA
Practice Address - Zip Code:16347-2494
Practice Address - Country:US
Practice Address - Phone:814-968-3636
Practice Address - Fax:814-968-3959
Is Sole Proprietor?:No
Enumeration Date:2021-01-27
Last Update Date:2021-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP044334L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist