Provider Demographics
NPI:1184252884
Name:MCGINTY, LISA PANTANO (RPH)
Entity type:Individual
Prefix:MRS
First Name:LISA
Middle Name:PANTANO
Last Name:MCGINTY
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 BACKFIELD DR
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:NC
Mailing Address - Zip Code:28570-8800
Mailing Address - Country:US
Mailing Address - Phone:252-241-4024
Mailing Address - Fax:
Practice Address - Street 1:1904 MARTIN LUTHER KING BLVD
Practice Address - Street 2:
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28560-4542
Practice Address - Country:US
Practice Address - Phone:252-672-4440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-29
Last Update Date:2020-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12857183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist