Provider Demographics
NPI:1336370584
Name:FREBIES MCGARRY, MARY M (RPH)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:M
Last Name:FREBIES MCGARRY
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:M
Other - Last Name:FREBIES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:7416 BURLISON DR. NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109
Mailing Address - Country:US
Mailing Address - Phone:505-822-8484
Mailing Address - Fax:505-856-0045
Practice Address - Street 1:7416 BURLISON DR NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-3968
Practice Address - Country:US
Practice Address - Phone:508-823-4783
Practice Address - Fax:505-717-1852
Is Sole Proprietor?:No
Enumeration Date:2009-08-06
Last Update Date:2009-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRP 5799183500000X
AZ7775183500000X
IL051031410183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist