Provider Demographics
NPI:1649732546
Name:MCCARTNEY, SAMANTHA JO (RPH)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:JO
Last Name:MCCARTNEY
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:PO BOX 108
Mailing Address - Street 2:
Mailing Address - City:MINDEN
Mailing Address - State:NE
Mailing Address - Zip Code:68959-0108
Mailing Address - Country:US
Mailing Address - Phone:308-832-2818
Mailing Address - Fax:308-832-2047
Practice Address - Street 1:419 N COLORADO AVE
Practice Address - Street 2:
Practice Address - City:MINDEN
Practice Address - State:NE
Practice Address - Zip Code:68959-1654
Practice Address - Country:US
Practice Address - Phone:308-832-2815
Practice Address - Fax:308-832-2047
Is Sole Proprietor?:No
Enumeration Date:2019-04-01
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE14264183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE14264OtherPHARMACIST LICENCE