Provider Demographics
NPI:1417567413
Name:MCKEE MEDICAL PHARMACY INC
Entity Type:Organization
Organization Name:MCKEE MEDICAL PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:AUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:WANG
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:408-923-8871
Mailing Address - Street 1:2350 MCKEE RD STE A3
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95116-1617
Mailing Address - Country:US
Mailing Address - Phone:408-923-8871
Mailing Address - Fax:408-259-4416
Practice Address - Street 1:2350 MCKEE RD STE A3
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95116-1617
Practice Address - Country:US
Practice Address - Phone:408-923-8871
Practice Address - Fax:408-259-4416
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-04
Last Update Date:2020-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy