Healthcare Provider Details

I. General information

NPI: 1003181769
Provider Name (Legal Business Name): ANTOINETTE MARIA MCDONALD PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TONI MARIA MCDONALD PHARMD

II. Dates (important events)

Enumeration Date: 03/14/2012
Last Update Date: 03/14/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

153 STEWART RD PHARMERICA
HANOVER TWP PA
18706-1486
US

IV. Provider business mailing address

11 HANNIS ST
ASHLEY PA
18706-1552
US

V. Phone/Fax

Practice location:
  • Phone: 570-821-0842
  • Fax: 800-577-7017
Mailing address:
  • Phone: 570-825-8847
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP039652L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: