Ira McCracken, PHARM.D.
Individual provider Active NPI Pharmacist · Marshfield, MO
NPI 1780161208 · NPPES record last updated Jul 26, 2018
Key facts
- NPI
- 1780161208
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 2001018846 (MO)
- Practice address
- 452 Forest Dr
Marshfield, MO 65706-2413 - Phone
- (417) 872-8836
- NPI assigned
- Jul 26, 2018
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2001018846 | MO | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 2001018846 | MO | Yes |
Addresses
Primary practice location
452 Forest Dr
Marshfield, MO 65706-2413
Mailing address
452 Forest Dr
Marshfield, MO 65706-2413
Phone (417) 872-8836
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2001018846 | Other | MO | MISSOURI BOARD OF PHARMACY |
Other providers in Marshfield, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 26, 2018. 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.