Provider Demographics
NPI:1932206943
Name:MCCAHAN, STEPHEN W (PHARMD)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:W
Last Name:MCCAHAN
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 1:3 HILLTOP ST
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:PA
Mailing Address - Zip Code:15537-1246
Mailing Address - Country:US
Mailing Address - Phone:814-652-5002
Mailing Address - Fax:
Practice Address - Street 1:108 E MAIN ST
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:PA
Practice Address - Zip Code:15537-1258
Practice Address - Country:US
Practice Address - Phone:814-652-5532
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP441007183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PARP441007OtherSTATE PHARMACIAT LICENSE