Provider Demographics
NPI:1386228732
Name:MCQUATE, GAVIN (PHARMD)
Entity type:Individual
Prefix:
First Name:GAVIN
Middle Name:
Last Name:MCQUATE
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 1:136A COURT ST
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:NH
Mailing Address - Zip Code:03820-4142
Mailing Address - Country:US
Mailing Address - Phone:603-534-0077
Mailing Address - Fax:
Practice Address - Street 1:53 ROUTE 27
Practice Address - Street 2:
Practice Address - City:RAYMOND
Practice Address - State:NH
Practice Address - Zip Code:03077-1224
Practice Address - Country:US
Practice Address - Phone:603-895-9842
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-11
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHPHCY-01120183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist