Provider Demographics
NPI:1710188677
Name:MCCLANAHAN, GREG LEE (RPH)
Entity Type:Individual
Prefix:MR
First Name:GREG
Middle Name:LEE
Last Name:MCCLANAHAN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:27500 OSCEOLA RD
Mailing Address - Street 2:
Mailing Address - City:ABINGDON
Mailing Address - State:VA
Mailing Address - Zip Code:24211-6460
Mailing Address - Country:US
Mailing Address - Phone:276-676-0937
Mailing Address - Fax:276-783-4115
Practice Address - Street 1:795 N MAIN ST
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:VA
Practice Address - Zip Code:24354-3403
Practice Address - Country:US
Practice Address - Phone:276-783-4115
Practice Address - Fax:276-483-1411
Is Sole Proprietor?:No
Enumeration Date:2007-05-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0202009416183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist