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General NPI Number Information
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NPI Number | 1639452824
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Entity Type | Individual
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Provider Name | JEANNA MCQUILLEN PHARMD
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Gender | Female
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Dates
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Enumeration Date | 09/23/2011
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Last Update Date | 09/23/2011
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Provider Practice Location Address
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Address Line | 663 E AURORA RD
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City | MACEDONIA
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State | OH
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Zip | 44056-2729
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Country | US
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Telephone | 330-468-4800
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Fax |
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Provider Business Mailing Address
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Address Line | 2211 CROCKETT CIR
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City | STOW
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State | OH
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Zip | 44224-7007
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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 | 03226456
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License Number State | OH
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