Provider Demographics
NPI:1043291669
Name:MCCLURES PHARMACY
Entity Type:Organization
Organization Name:MCCLURES PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LORNAIL
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCLURE
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:501-825-6265
Mailing Address - Street 1:PO BOX 1291
Mailing Address - Street 2:
Mailing Address - City:GREERS FERRY
Mailing Address - State:AR
Mailing Address - Zip Code:72067-1291
Mailing Address - Country:US
Mailing Address - Phone:501-825-6265
Mailing Address - Fax:501-825-7556
Practice Address - Street 1:8470 EDGEMONT RD
Practice Address - Street 2:
Practice Address - City:GREERS FERRY
Practice Address - State:AR
Practice Address - Zip Code:72067-9742
Practice Address - Country:US
Practice Address - Phone:501-825-6265
Practice Address - Fax:501-825-7556
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
0703270001Medicare ID - Type Unspecified