Provider Demographics
NPI:1184850059
Name:MCPHERSON VACCINATION SERVICES
Entity Type:Organization
Organization Name:MCPHERSON VACCINATION SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:DON
Authorized Official - Middle Name:R
Authorized Official - Last Name:ELLIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-635-2385
Mailing Address - Street 1:1921 CARNEGIE AVE STE 3K
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-5510
Mailing Address - Country:US
Mailing Address - Phone:800-635-2385
Mailing Address - Fax:949-851-8765
Practice Address - Street 1:1921 CARNEGIE AVE STE 3K
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-5510
Practice Address - Country:US
Practice Address - Phone:800-635-2385
Practice Address - Fax:949-851-8765
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-05
Last Update Date:2009-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care