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General NPI Number Information
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NPI Number | 1033577929
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Entity Type | Individual
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Provider Name | MARK MCGRANAHAN JR. R.PH.
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Gender | Male
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Dates
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Enumeration Date | 02/05/2016
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Last Update Date | 02/05/2016
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Provider Practice Location Address
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Address Line | 3105 N BEND RD
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City | HEBRON
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State | KY
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Zip | 41048-8523
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Country | US
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Telephone | 859-962-4920
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Fax |
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Provider Business Mailing Address
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Address Line | 1774 NICOLE LAUREN LN
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City | HEBRON
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State | KY
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Zip | 41048-8118
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 26020318A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 014253
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 03124466
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License Number State | OH
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