Provider Demographics
NPI:1780192302
Name:MCCLAIN, CHRIS (RPH)
Entity Type:Individual
Prefix:MR
First Name:CHRIS
Middle Name:
Last Name:MCCLAIN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 CAMPUS PLACE
Mailing Address - Street 2:SUITE #100
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40299
Mailing Address - Country:US
Mailing Address - Phone:877-662-6633
Mailing Address - Fax:502-849-0642
Practice Address - Street 1:1901 CAMPUS PLACE
Practice Address - Street 2:SUITE 100
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40299
Practice Address - Country:US
Practice Address - Phone:877-662-6633
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-17
Last Update Date:2018-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY019475183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist