Provider Demographics
NPI:1346766888
Name:MCDERMOTT, MARY ANN (RPH)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:ANN
Last Name:MCDERMOTT
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1505 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45013-1079
Mailing Address - Country:US
Mailing Address - Phone:513-737-0894
Mailing Address - Fax:
Practice Address - Street 1:1505 MAIN ST
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45013-1079
Practice Address - Country:US
Practice Address - Phone:513-737-0894
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03318399183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist