Provider Demographics
NPI:1215050257
Name:MCGARITY, ROCKY L (RPH)
Entity type:Individual
Prefix:
First Name:ROCKY
Middle Name:L
Last Name:MCGARITY
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8625 GRANT RD
Mailing Address - Street 2:
Mailing Address - City:WILMER
Mailing Address - State:AL
Mailing Address - Zip Code:36587-3055
Mailing Address - Country:US
Mailing Address - Phone:251-649-2080
Mailing Address - Fax:
Practice Address - Street 1:103 W FRONTAGE RD
Practice Address - Street 2:STE A
Practice Address - City:LUCEDALE
Practice Address - State:MS
Practice Address - Zip Code:39452-5836
Practice Address - Country:US
Practice Address - Phone:601-947-4941
Practice Address - Fax:601-766-3010
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2016-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE7918183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS0330314Medicaid
MS0440455Medicaid
MS122018001Medicare NSC