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General NPI Number Information
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NPI Number | 1619775913
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Entity Type | Individual
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Provider Name | MCKENZIE MCKAY PHARMD
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Gender | Female
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Dates
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Enumeration Date | 03/04/2025
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Last Update Date | 03/04/2025
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Provider Practice Location Address
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Address Line | 1071 W BROADWAY
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City | CENTRALIA
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State | IL
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Zip | 62801-5309
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Country | US
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Telephone | 618-532-2200
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Fax |
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Provider Business Mailing Address
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Address Line | 858 N IRELAND LN
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City | BELLE RIVE
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State | IL
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Zip | 62810-3709
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Country | US
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Telephone | 618-327-6709
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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 | 051306486
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License Number State | IL
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