Healthcare Provider Details

I. General information

NPI: 1619099074
Provider Name (Legal Business Name): VICTORIA L MCCARTHY PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/05/2007
Last Update Date: 10/17/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

989200 NEBRASKA MEDICAL CTR
OMAHA NE
68198-3113
US

IV. Provider business mailing address

16427 YATES ST
OMAHA NE
68116-2508
US

V. Phone/Fax

Practice location:
  • Phone: 402-559-2484
  • Fax: 402-559-2411
Mailing address:
  • Phone: 402-496-4758
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number11736
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: