Provider Demographics
NPI:1275530180
Name:MCGAW RX, INC
Entity Type:Organization
Organization Name:MCGAW RX, INC
Other - Org Name:MEDICINE SHOPPE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:J
Authorized Official - Last Name:MCGAW
Authorized Official - Suffix:
Authorized Official - Credentials:BS, PHARM D
Authorized Official - Phone:850-623-3211
Mailing Address - Street 1:5326 STEWART ST
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:FL
Mailing Address - Zip Code:32570-4736
Mailing Address - Country:US
Mailing Address - Phone:850-623-3211
Mailing Address - Fax:850-623-2353
Practice Address - Street 1:5326 STEWART ST
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:FL
Practice Address - Zip Code:32570-4736
Practice Address - Country:US
Practice Address - Phone:850-623-3211
Practice Address - Fax:850-623-2353
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-07
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL19927333600000X
FL3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1060021OtherNCPDP #
AL100200082Medicaid
FL0266540001Medicaid
FL026654000Medicaid
FL026654000Medicaid
FL026654000Medicaid