Organization
MCCLOUD FAMILY PHARMACY INC
Active
Other names
MCCLOUD FAMILY PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN MCCLOUD RPH (OWNER,PIC,AO)
(304) 522-6090
Entity
Organization
Contact information
Practice address
4541 5TH STREET RD, HUNTINGTON, WV 25701-9112
(304) 522-6090
(304) 522-6094
Mailing address
PO BOX 909, LAVALETTE, WV 25535-0909
(304) 522-6090
(304) 522-6094
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
SP0552325
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2111570
PK
—
05
—
3810004197
—
WV
Enumeration date
06/13/2006
Last updated
07/17/2015
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