Provider Demographics
NPI:1770187080
Name:MCCLEAN, RYAN CHARLES (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:CHARLES
Last Name:MCCLEAN
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 LAURA LN
Mailing Address - Street 2:
Mailing Address - City:UNIONTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15401-6582
Mailing Address - Country:US
Mailing Address - Phone:724-323-4222
Mailing Address - Fax:
Practice Address - Street 1:25 PITTSBURGH ST
Practice Address - Street 2:
Practice Address - City:UNIONTOWN
Practice Address - State:PA
Practice Address - Zip Code:15401-2943
Practice Address - Country:US
Practice Address - Phone:724-438-5443
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-27
Last Update Date:2020-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP437663183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist