Provider Demographics
NPI:1740501790
Name:MCMAHON, LAURA ANN (PHARM D)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:ANN
Last Name:MCMAHON
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:546 WATERBURY DR
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-6060
Mailing Address - Country:US
Mailing Address - Phone:724-832-1632
Mailing Address - Fax:724-834-1218
Practice Address - Street 1:6090 ROUTE 30
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-1279
Practice Address - Country:US
Practice Address - Phone:724-837-4180
Practice Address - Fax:724-834-1218
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-14
Last Update Date:2010-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP438484183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist