Provider Demographics
NPI:1508156035
Name:MCCOY, DARLENE ANNE
Entity Type:Individual
Prefix:
First Name:DARLENE
Middle Name:ANNE
Last Name:MCCOY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:182 TULPEHOCKEN ST
Mailing Address - Street 2:
Mailing Address - City:BERNVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19506-8986
Mailing Address - Country:US
Mailing Address - Phone:610-488-1695
Mailing Address - Fax:
Practice Address - Street 1:2320 PENN AVE
Practice Address - Street 2:
Practice Address - City:WEST LAWN
Practice Address - State:PA
Practice Address - Zip Code:19609-1675
Practice Address - Country:US
Practice Address - Phone:610-678-2909
Practice Address - Fax:610-678-0258
Is Sole Proprietor?:No
Enumeration Date:2011-04-18
Last Update Date:2011-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP034788L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist