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IRA MCCRACKEN PHARM.D.

>> Pharmacist >> Pharmacy Service Providers

Registrant NPI Number: 1780161208

Individual Registrant:
 IRA  MCCRACKEN PHARM.D.
Gender: M
Sole Proprietor

Location and contact information for practice:
452 FOREST DR  MARSHFIELD, MO 65706-2413 US
Tel: 417-872-8836  Fax: --

Contact information for business:
452 FOREST DR  MARSHFIELD, MO 65706-2413 US
Tel: 417-872-8836  Fax: --

Registration Information:
NPI: 1780161208
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y183500000XPharmacy Service Providers
Pharmacist
MO2001018846

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
MISSOURI BOARD OF PHARMACY2001018846MO01




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