Provider Demographics
NPI:1447089446
Name:MCGRAIN, KELLY (PHARMD)
Entity type:Individual
Prefix:
First Name:KELLY
Middle Name:
Last Name:MCGRAIN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14236 GREENSBURG PIKE
Mailing Address - Street 2:
Mailing Address - City:PORTAGE
Mailing Address - State:OH
Mailing Address - Zip Code:43451-9763
Mailing Address - Country:US
Mailing Address - Phone:419-265-0888
Mailing Address - Fax:
Practice Address - Street 1:1200 MEDICAL CENTER PKWY STE E
Practice Address - Street 2:
Practice Address - City:MAUMEE
Practice Address - State:OH
Practice Address - Zip Code:43537-1921
Practice Address - Country:US
Practice Address - Phone:419-383-5980
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-29
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH033311191835X0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835X0200XPharmacy Service ProvidersPharmacistOncology