Provider Demographics
NPI:1457026510
Name:MCLAIN, CARSON ANDREW (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:CARSON
Middle Name:ANDREW
Last Name:MCLAIN
Suffix:
Gender:M
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:PO BOX 2090
Mailing Address - Street 2:
Mailing Address - City:BLANCHARD
Mailing Address - State:OK
Mailing Address - Zip Code:73010-2090
Mailing Address - Country:US
Mailing Address - Phone:405-485-9311
Mailing Address - Fax:405-485-9312
Practice Address - Street 1:301 NE 10TH ST
Practice Address - Street 2:
Practice Address - City:BLANCHARD
Practice Address - State:OK
Practice Address - Zip Code:73010-9817
Practice Address - Country:US
Practice Address - Phone:405-485-9311
Practice Address - Fax:405-485-9312
Is Sole Proprietor?:No
Enumeration Date:2021-08-11
Last Update Date:2021-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK19308183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist