Provider Demographics
NPI:1174108948
Name:MCCARTY, KELLI ANN (PHARMD, RPH)
Entity type:Individual
Prefix:DR
First Name:KELLI
Middle Name:ANN
Last Name:MCCARTY
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 MARIANO BISHOP BLVD
Mailing Address - Street 2:
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02721-2349
Mailing Address - Country:US
Mailing Address - Phone:508-675-0887
Mailing Address - Fax:
Practice Address - Street 1:333 MARIANO BISHOP BLVD
Practice Address - Street 2:
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02721-2349
Practice Address - Country:US
Practice Address - Phone:508-675-0887
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-13
Last Update Date:2021-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRPH05913183500000X
MAPH238268183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist