Provider Demographics
NPI:1740465673
Name:MCNALLY, EVERETT WELLINGTON III (PHARMD)
Entity type:Individual
Prefix:DR
First Name:EVERETT
Middle Name:WELLINGTON
Last Name:MCNALLY
Suffix:III
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:JIMMIE
Other - Middle Name:RODGERS
Other - Last Name:MCNALLY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7 TEAKWOOD KNLS
Mailing Address - Street 2:
Mailing Address - City:LEWISTON
Mailing Address - State:ME
Mailing Address - Zip Code:04240-2423
Mailing Address - Country:US
Mailing Address - Phone:207-513-2254
Mailing Address - Fax:
Practice Address - Street 1:111 FRANKLIN HEALTH CMNS
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:ME
Practice Address - Zip Code:04938-6144
Practice Address - Country:US
Practice Address - Phone:207-779-2436
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-09
Last Update Date:2011-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHR2073183500000X
FLPS41273183500000X
MEPR5591183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist