Provider Demographics
NPI:1962238121
Name:MCNAMARA, MADALYN (PHARMD)
Entity type:Individual
Prefix:
First Name:MADALYN
Middle Name:
Last Name:MCNAMARA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:MADALYN
Other - Middle Name:
Other - Last Name:WEAVER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10503 SOUTHERWICK PL
Mailing Address - Street 2:
Mailing Address - City:JOHNSTON
Mailing Address - State:IA
Mailing Address - Zip Code:50131-2561
Mailing Address - Country:US
Mailing Address - Phone:815-861-5839
Mailing Address - Fax:
Practice Address - Street 1:700 E UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50316-2392
Practice Address - Country:US
Practice Address - Phone:515-263-5510
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-12
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA24798183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist