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General NPI Number Information
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NPI Number | 1306073424
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Entity Type | Individual
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Provider Name | JOHN RYAN MCGRATH PHARMD
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Gender | Male
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Dates
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Enumeration Date | 06/16/2009
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Last Update Date | 06/25/2021
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Provider Practice Location Address
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Address Line | 377TH MEDICAL GROUP 1501 SAN PEDRO ST BLDG 47
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City | ALBUQUERQUE
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State | NM
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Zip | 87117-2512
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Country | US
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Telephone | 505-846-3133
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Fax |
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Provider Business Mailing Address
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Address Line | 7901 GIBSON BLVD BLDG 20176
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City | ALBUQUERQUE
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State | NM
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Zip | 87117-0001
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Country | US
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Telephone | 58-463-1335
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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 | RP442997
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License Number State | PA
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