Provider Demographics
NPI:1992432413
Name:MCHANEY, SAMUEL PARRISH (PHARMD)
Entity type:Individual
Prefix:MR
First Name:SAMUEL
Middle Name:PARRISH
Last Name:MCHANEY
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 1:1400 WEST HUNT STREET
Mailing Address - Street 2:
Mailing Address - City:PARAGOULD
Mailing Address - State:AR
Mailing Address - Zip Code:72450
Mailing Address - Country:US
Mailing Address - Phone:870-236-3180
Mailing Address - Fax:870-239-2354
Practice Address - Street 1:1400 WEST HUNT STREET
Practice Address - Street 2:
Practice Address - City:PARAGOULD
Practice Address - State:AR
Practice Address - Zip Code:72450
Practice Address - Country:US
Practice Address - Phone:870-236-3180
Practice Address - Fax:870-239-2354
Is Sole Proprietor?:No
Enumeration Date:2022-08-04
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD08730183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist