Healthcare Provider Details

I. General information

NPI: 1285769711
Provider Name (Legal Business Name): EVERETT B MCALLISTER RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/23/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 LUKE AVENUE
BOLLING AIR FORCE BASE DC
20032-6400
US

IV. Provider business mailing address

PO BOX 8370
WASHINGTON DC
20032-8370
US

V. Phone/Fax

Practice location:
  • Phone: 202-767-5405
  • Fax:
Mailing address:
  • Phone: 202-767-5405
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number6227
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: