Organization
L B MCCLAREN
Active
Other names
L B MCCLAREN PHARMACIST
Organization subpart
No
Provider details
NPI number
Authorized official
L MCCLAREN PD (OWNER)
(731) 784-2621
Entity
Organization
Contact information
Practice address
1301 E MAIN ST, HUMBOLDT, TN 38343-3327
(731) 784-4748
(731) 784-6838
Mailing address
2502 CHERE CAROL RD, HUMBOLDT, TN 38343-3507
(731) 784-4748
(731) 784-6838
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
1225
TN
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4406927
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
11/17/2006
Last updated
02/03/2012
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