Provider Demographics
NPI:1164011870
Name:MCGUIRE, PATRICIA ELISE
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:ELISE
Last Name:MCGUIRE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2324 US HIGHWAY 17
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HILL
Mailing Address - State:GA
Mailing Address - Zip Code:31324-3398
Mailing Address - Country:US
Mailing Address - Phone:912-756-2531
Mailing Address - Fax:912-756-2558
Practice Address - Street 1:2324 US HIGHWAY 17
Practice Address - Street 2:
Practice Address - City:RICHMOND HILL
Practice Address - State:GA
Practice Address - Zip Code:31324-3398
Practice Address - Country:US
Practice Address - Phone:912-756-2531
Practice Address - Fax:912-756-2558
Is Sole Proprietor?:No
Enumeration Date:2021-01-16
Last Update Date:2021-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPHTC005396183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician