MEDICARE: JACQUELINE A MCCRAY DPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	13692	LA

General Provider Information

NPI Number	:	1578870739
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JACQUELINE A MCCRAY DPH

Provider Business Mailing Address
First Line	:	2640 WAGGONER AVE
Second Line	:
City	:	SHREVEPORT
State	:	LA
Zip	:	71108-3859
Country	:	US
Telephone Number	:	318-631-2065
Fax Number	:	318-631-2067

Provider Business Practice Location Address
First Line	:	2640 WAGGONER AVE
Second Line	:
City	:	SHREVEPORT
State	:	LA
Zip	:	71108-3859
Country	:	US
Telephone Number	:	318-631-2065
Fax Number	:	318-631-2067

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/09/2010
Last Update Date	:	09/10/2010

Similar Medicare Providers

1780757252 — BROOKSHIRE GROCERY COMPANY
Practice Location Address:

2640 WAGGONER AVE , ATTENTION PHARMACY DEPT
SHREVEPORT, LA
71108-3859

Practice Phone: 318-631-2065
Practice Fax: 318-631-2067

1629337316 — MR. THOMAS FISHER RPH
Practice Location Address:

2640 WAGGONER AVE
SHREVEPORT, LA
71108-3859

Practice Phone: 318-631-2065
Practice Fax:

1942924287 — DR. DESTINY DUBOSE PHARM.D
Practice Location Address:

2640 WAGGONER AVE
SHREVEPORT, LA
71108-3859

Practice Phone: 318-631-2065
Practice Fax:

1447937701 — WALGREEN CO.
Practice Location Address:

2640 WAGGONER AVE
SHREVEPORT, LA
71108-3859

Practice Phone: 318-631-2065
Practice Fax:

1790798080 — PATTI F. BORNAMAN M.A.
Practice Location Address:

9435 MANSFIELD RD , SUITE 3B
SHREVEPORT, LA
71118-3859

Practice Phone: 318-686-0012
Practice Fax: 318-686-0012

1962970582 — TOTAL HEALTH FAMILY MEDICINE
Practice Location Address:

9435 MANSFIELD RD STE 5B
SHREVEPORT, LA
71118-3859

Practice Phone: 318-686-3770
Practice Fax: 318-686-3838

Directions to “ JACQUELINE A MCCRAY DPH” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.