Healthcare Provider Details

I. General information

NPI: 1720463417
Provider Name (Legal Business Name): MCNAMEE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2015
Last Update Date: 07/23/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

412 CENTRAL AVE
SOUTH WILLIAMSON KY
41503-4121
US

IV. Provider business mailing address

PO BOX 748
WILLIAMSON WV
25661-0748
US

V. Phone/Fax

Practice location:
  • Phone: 606-237-7430
  • Fax: 606-237-7438
Mailing address:
  • Phone: 304-235-3535
  • Fax: 304-235-1258

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberP07697
License Number StateKY

VIII. Authorized Official

Name: MRS. NICOLE DENISE MCNAMEE
Title or Position: PRESIDENT
Credential: PHARMD
Phone: 304-235-3535