Provider Demographics
NPI:1427403344
Name:MCCART, NICOLE BROOKE (PHARMD)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:BROOKE
Last Name:MCCART
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:264 S HOLLYWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:STEUBENVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43952-2422
Mailing Address - Country:US
Mailing Address - Phone:740-266-2893
Mailing Address - Fax:
Practice Address - Street 1:264 S HOLLYWOOD BLVD
Practice Address - Street 2:
Practice Address - City:STEUBENVILLE
Practice Address - State:OH
Practice Address - Zip Code:43952-2422
Practice Address - Country:US
Practice Address - Phone:740-266-2893
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-28
Last Update Date:2016-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03326757183500000X
WVRP0006945183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist