Provider Demographics
NPI:1780024471
Name:MCCLEERY, REBECCA (PHARM D)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:MCCLEERY
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5547 195TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:NEW LONDON
Mailing Address - State:MN
Mailing Address - Zip Code:56273-9458
Mailing Address - Country:US
Mailing Address - Phone:320-354-3062
Mailing Address - Fax:
Practice Address - Street 1:1600 1ST ST S
Practice Address - Street 2:
Practice Address - City:WILLMAR
Practice Address - State:MN
Practice Address - Zip Code:56201-4227
Practice Address - Country:US
Practice Address - Phone:320-235-1930
Practice Address - Fax:320-235-7801
Is Sole Proprietor?:No
Enumeration Date:2013-06-27
Last Update Date:2013-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN115986183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist