Healthcare Provider Details

I. General information

NPI: 1780024471
Provider Name (Legal Business Name): REBECCA MCCLEERY PHARM. D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2013
Last Update Date: 06/27/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 1ST ST S
WILLMAR MN
56201-4227
US

IV. Provider business mailing address

5547 195TH AVE NE
NEW LONDON MN
56273-9458
US

V. Phone/Fax

Practice location:
  • Phone: 320-235-1930
  • Fax: 320-235-7801
Mailing address:
  • Phone: 320-354-3062
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number115986
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: