Provider Demographics
NPI:1588175897
Name:MCCAFFREY, JODI (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JODI
Middle Name:
Last Name:MCCAFFREY
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 1:417 PAYNE RD
Mailing Address - Street 2:
Mailing Address - City:SCARBOROUGH
Mailing Address - State:ME
Mailing Address - Zip Code:04074-9594
Mailing Address - Country:US
Mailing Address - Phone:207-510-3005
Mailing Address - Fax:
Practice Address - Street 1:417 PAYNE RD
Practice Address - Street 2:
Practice Address - City:SCARBOROUGH
Practice Address - State:ME
Practice Address - Zip Code:04074-9594
Practice Address - Country:US
Practice Address - Phone:207-510-3005
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-14
Last Update Date:2017-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPR46966183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist