Provider Demographics
NPI:1427158112
Name:MCDONALD, PRESTON E (RPH/BPHARM)
Entity type:Individual
Prefix:MR
First Name:PRESTON
Middle Name:E
Last Name:MCDONALD
Suffix:
Gender:M
Credentials:RPH/BPHARM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8814 N PALAFOX ST # C
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32534-3029
Mailing Address - Country:US
Mailing Address - Phone:850-473-0428
Mailing Address - Fax:850-473-3958
Practice Address - Street 1:8814 N PALAFOX ST # C
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32534-3029
Practice Address - Country:US
Practice Address - Phone:850-473-0428
Practice Address - Fax:850-473-3958
Is Sole Proprietor?:No
Enumeration Date:2006-09-23
Last Update Date:2014-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS33121183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPU7008OtherFLORIDA