Provider Demographics
NPI:1437466919
Name:RANKIN, MACKENZIE LEE (PHARMD)
Entity Type:Individual
Prefix:
First Name:MACKENZIE
Middle Name:LEE
Last Name:RANKIN
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 1:17 RINGNECK DR
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17112-1423
Mailing Address - Country:US
Mailing Address - Phone:717-437-3508
Mailing Address - Fax:
Practice Address - Street 1:10 NEWPORT PL
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:PA
Practice Address - Zip Code:17074-8736
Practice Address - Country:US
Practice Address - Phone:717-567-6670
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-07
Last Update Date:2010-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP444598183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist