Provider Demographics
NPI:1104100858
Name:MCKINNEY, JOACHIM YVES (PHARM D)
Entity type:Individual
Prefix:DR
First Name:JOACHIM
Middle Name:YVES
Last Name:MCKINNEY
Suffix:
Gender:M
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 1:4454 CAL STEENS RD
Mailing Address - Street 2:
Mailing Address - City:CALEDONIA
Mailing Address - State:MS
Mailing Address - Zip Code:39740-8677
Mailing Address - Country:US
Mailing Address - Phone:662-327-0079
Mailing Address - Fax:662-328-5007
Practice Address - Street 1:4454 CAL STEENS RD
Practice Address - Street 2:
Practice Address - City:CALEDONIA
Practice Address - State:MS
Practice Address - Zip Code:39740-8677
Practice Address - Country:US
Practice Address - Phone:662-327-0079
Practice Address - Fax:662-328-5007
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-29
Last Update Date:2011-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE-9303183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist