Provider Demographics
NPI:1568781722
Name:MCGLEINNAISS, CARRIE ANN (PHARM D)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:ANN
Last Name:MCGLEINNAISS
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:CARRIE
Other - Middle Name:ANN
Other - Last Name:MCGINNESS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARM D
Mailing Address - Street 1:2105 S 182ND CIR
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68130-2775
Mailing Address - Country:US
Mailing Address - Phone:415-860-4814
Mailing Address - Fax:402-881-3533
Practice Address - Street 1:11350 WICKERSHAM BLVD
Practice Address - Street 2:WAL-MART PHARMACY
Practice Address - City:GRETNA
Practice Address - State:NE
Practice Address - Zip Code:68028
Practice Address - Country:US
Practice Address - Phone:402-881-3687
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-26
Last Update Date:2017-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA27150183500000X
NC19179183500000X
NE127471835P1200X, 183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy