Provider Demographics
NPI:1235489600
Name:MCCLURE, RICHARD PEPPER (RPH)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:PEPPER
Last Name:MCCLURE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:MR
Other - First Name:RICHARD
Other - Middle Name:PEPPER
Other - Last Name:MCCLURE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RPH
Mailing Address - Street 1:4400 DORCHESTER RD
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29405
Mailing Address - Country:US
Mailing Address - Phone:843-744-6506
Mailing Address - Fax:843-554-3594
Practice Address - Street 1:4400 DORCHESTER RD
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29405
Practice Address - Country:US
Practice Address - Phone:843-744-6506
Practice Address - Fax:843-554-3594
Is Sole Proprietor?:No
Enumeration Date:2012-09-13
Last Update Date:2012-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC006494183500000X
FLPS 22479183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist