Provider Demographics
NPI:1144718206
Name:MCALLISTER, JOSEPH ANDREW (RPH)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:ANDREW
Last Name:MCALLISTER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:612 W MARINE CORPS DR STE 8
Mailing Address - Street 2:
Mailing Address - City:DEDEDO
Mailing Address - State:GU
Mailing Address - Zip Code:96929-5629
Mailing Address - Country:US
Mailing Address - Phone:671-637-3323
Mailing Address - Fax:
Practice Address - Street 1:612 W MARINE CORPS DR STE 8
Practice Address - Street 2:
Practice Address - City:DEDEDO
Practice Address - State:GU
Practice Address - Zip Code:96929-5629
Practice Address - Country:US
Practice Address - Phone:671-637-3323
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-24
Last Update Date:2018-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GUPH0112183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist