MEDICARE: DR. MARY ANN MCCOY PHARMD.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	51342	CA

General Provider Information

NPI Number	:	1720068349
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARY ANN MCCOY PHARMD.

Provider Business Mailing Address
First Line	:	255 BARCELONA CT
Second Line	:
City	:	LEMOORE
State	:	CA
Zip	:	93245-9063
Country	:	US
Telephone Number	:	559-924-3186
Fax Number	:

Provider Business Practice Location Address
First Line	:	105 W HANFORD ARMONA RD
Second Line	:
City	:	LEMOORE
State	:	CA
Zip	:	93245-2321
Country	:	US
Telephone Number	:	559-924-9593
Fax Number	:	559-924-5799

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/19/2006
Last Update Date	:	07/08/2007

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