Provider Demographics
NPI:1851688675
Name:MCNAMARA, KEVIN EMMETT (RPH)
Entity Type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:EMMETT
Last Name:MCNAMARA
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 TURNPIKE RD
Mailing Address - Street 2:
Mailing Address - City:WESTBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01581-2813
Mailing Address - Country:US
Mailing Address - Phone:508-366-4475
Mailing Address - Fax:508-366-4475
Practice Address - Street 1:3 GLEN ST
Practice Address - Street 2:
Practice Address - City:WESTBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01581-3705
Practice Address - Country:US
Practice Address - Phone:508-783-8479
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-30
Last Update Date:2011-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH24227183500000X
CTPCT.0008704183500000X
RIRPH03960183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist