Provider Demographics
NPI:1881119956
Name:MCENANY, PHILLIP GENE JR (PHARMD)
Entity type:Individual
Prefix:DR
First Name:PHILLIP
Middle Name:GENE
Last Name:MCENANY
Suffix:JR
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:730 N 68TH AVE
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33024-7521
Mailing Address - Country:US
Mailing Address - Phone:954-849-1662
Mailing Address - Fax:
Practice Address - Street 1:15911 PINES BLVD
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33027-1201
Practice Address - Country:US
Practice Address - Phone:954-450-8896
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-09
Last Update Date:2017-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS56807183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist