Provider Demographics
NPI:1639490733
Name:MCQUIGHAN, BRENDON (PHARMD)
Entity Type:Individual
Prefix:
First Name:BRENDON
Middle Name:
Last Name:MCQUIGHAN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 LEE AIRPARK DR
Mailing Address - Street 2:
Mailing Address - City:EDGEWATER
Mailing Address - State:MD
Mailing Address - Zip Code:21037-1237
Mailing Address - Country:US
Mailing Address - Phone:410-956-4150
Mailing Address - Fax:
Practice Address - Street 1:13 LEE AIRPARK DR
Practice Address - Street 2:
Practice Address - City:EDGEWATER
Practice Address - State:MD
Practice Address - Zip Code:21037-1237
Practice Address - Country:US
Practice Address - Phone:410-956-4150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-13
Last Update Date:2017-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD20183183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist