Cynthia Kennedy McDonald, D.PH.
Individual provider Active NPI Pharmacist · Winchester, TN
NPI 1184055899 · NPPES record last updated Dec 5, 2013
Key facts
- NPI
- 1184055899
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 7368 (TN)
- Practice address
- 1201 Dinah Shore Blvd
Winchester, TN 37398-1107 - Phone
- (931) 967-2777
- NPI assigned
- Dec 5, 2013
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7368 | TN | MD | Mental Health Counselor |
| 11708 | AL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carol H Wallace | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 7368 | TN | Yes |
| Pharmacist | 183500000X | 11708 | AL |
Addresses
Primary practice location
1201 Dinah Shore Blvd
Winchester, TN 37398-1107
Mailing address
117 Chadwick Farms Dr
Fayetteville, TN 37334-6081
Phone (931) 625-2040
Other providers in Winchester, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 5, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.