Healthcare Provider Details

I. General information

NPI: 1962238121
Provider Name (Legal Business Name): MADALYN MCNAMARA PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MADALYN WEAVER

II. Dates (important events)

Enumeration Date: 09/12/2024
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3600 30TH ST
DES MOINES IA
50310-5753
US

IV. Provider business mailing address

10503 SOUTHERWICK PL
JOHNSTON IA
50131-2561
US

V. Phone/Fax

Practice location:
  • Phone: 515-699-5999
  • Fax:
Mailing address:
  • Phone: 815-861-5839
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number24798
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: