Provider Demographics
NPI:1538433594
Name:MCCRIMMON, DAN JR (RPH)
Entity type:Individual
Prefix:MR
First Name:DAN
Middle Name:
Last Name:MCCRIMMON
Suffix:JR
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 1:2805 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27263-1936
Mailing Address - Country:US
Mailing Address - Phone:336-431-1149
Mailing Address - Fax:336-431-8423
Practice Address - Street 1:2805 S MAIN ST
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27263-1936
Practice Address - Country:US
Practice Address - Phone:336-431-1149
Practice Address - Fax:336-431-8423
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-08
Last Update Date:2012-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC08765183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist