Provider Demographics
NPI:1205822475
Name:LEON M MCLEAN AND STEVEN A MCLEAN INC
Entity Type:Organization
Organization Name:LEON M MCLEAN AND STEVEN A MCLEAN INC
Other - Org Name:MEDICINE SHOPPE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:A
Authorized Official - Last Name:MCLEAN
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:910-276-7210
Mailing Address - Street 1:801 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LAURINBURG
Mailing Address - State:NC
Mailing Address - Zip Code:28352-4724
Mailing Address - Country:US
Mailing Address - Phone:910-276-7210
Mailing Address - Fax:910-276-2584
Practice Address - Street 1:801 S MAIN ST
Practice Address - Street 2:
Practice Address - City:LAURINBURG
Practice Address - State:NC
Practice Address - Zip Code:28352-4724
Practice Address - Country:US
Practice Address - Phone:910-276-7210
Practice Address - Fax:910-276-2584
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-23
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC04196332B00000X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3420180OtherNCPDP #
NC0835173Medicaid
NC7701496Medicaid
NC7701496Medicaid
NCAM1926647OtherDEA #
NC3420180OtherNCPDP #