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General NPI Number Information
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NPI Number | 1699366583
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Entity Type | Individual
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Provider Name | JEREMY MCANERNEY PHARMD
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Gender | Male
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Dates
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Enumeration Date | 02/02/2021
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Last Update Date | 02/02/2021
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Provider Practice Location Address
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Address Line | 1201 NW 12TH ST
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City | MOORE
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State | OK
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Zip | 73170-1220
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Country | US
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Telephone | 405-799-1081
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Fax |
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Provider Business Mailing Address
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Address Line | 12722 N MACARTHUR BLVD APT J
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City | OKLAHOMA CITY
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State | OK
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Zip | 73142-2913
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Country | US
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Telephone | 405-655-0961
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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 | 16940
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License Number State | NE
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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 | 18827
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License Number State | OK
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