Provider Demographics
NPI:1407494776
Name:MCCLAIN, MARCI MEREDITH (PHARMD)
Entity Type:Individual
Prefix:
First Name:MARCI
Middle Name:MEREDITH
Last Name:MCCLAIN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 RIVERFRONT DR APT 105
Mailing Address - Street 2:
Mailing Address - City:NORTH LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72114-5658
Mailing Address - Country:US
Mailing Address - Phone:501-231-2778
Mailing Address - Fax:
Practice Address - Street 1:8824 GEYER SPRINGS RD
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72209-4765
Practice Address - Country:US
Practice Address - Phone:501-565-7584
Practice Address - Fax:501-565-5094
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-17
Last Update Date:2019-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD08367183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist