Provider Demographics
NPI:1548860505
Name:MCGURK, PATRICIA WALSH (RPH)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:WALSH
Last Name:MCGURK
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2420 DACIA DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19810-2604
Mailing Address - Country:US
Mailing Address - Phone:302-893-4790
Mailing Address - Fax:
Practice Address - Street 1:704 NAAMANS RD
Practice Address - Street 2:
Practice Address - City:CLAYMONT
Practice Address - State:DE
Practice Address - Zip Code:19703-1610
Practice Address - Country:US
Practice Address - Phone:302-798-0249
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-29
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEA10001947183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist