Provider Demographics
NPI:1285016360
Name:MCCREIGHT, JOSEPH MARVIN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:MARVIN
Last Name:MCCREIGHT
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5942 RED BUG LAKE RD
Mailing Address - Street 2:
Mailing Address - City:WINTER SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32708-5035
Mailing Address - Country:US
Mailing Address - Phone:321-316-4615
Mailing Address - Fax:321-316-4619
Practice Address - Street 1:5942 RED BUG LAKE RD
Practice Address - Street 2:
Practice Address - City:WINTER SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32708-5035
Practice Address - Country:US
Practice Address - Phone:321-316-4615
Practice Address - Fax:321-316-4619
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-24
Last Update Date:2015-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS 38901183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist