Provider Demographics
NPI:1255962924
Name:MCGUIRE, CARLYLE B (PHARMD)
Entity type:Individual
Prefix:
First Name:CARLYLE
Middle Name:B
Last Name:MCGUIRE
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 1:705 ARKANSAS ST APT C
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66044-2350
Mailing Address - Country:US
Mailing Address - Phone:914-484-3848
Mailing Address - Fax:
Practice Address - Street 1:120 E 19TH ST
Practice Address - Street 2:
Practice Address - City:OTTAWA
Practice Address - State:KS
Practice Address - Zip Code:66067-4300
Practice Address - Country:US
Practice Address - Phone:785-242-4649
Practice Address - Fax:785-242-2401
Is Sole Proprietor?:No
Enumeration Date:2020-01-30
Last Update Date:2022-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20190291021835P0018X
KS1-1098981835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist