Provider Demographics
NPI:1801409347
Name:MCCLENDON, ANGELA DENISE (PHARMD)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:DENISE
Last Name:MCCLENDON
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 1:2147 DOGWOOD CREEK CT APT 102
Mailing Address - Street 2:
Mailing Address - City:COLLIERVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38017-7889
Mailing Address - Country:US
Mailing Address - Phone:601-497-0149
Mailing Address - Fax:
Practice Address - Street 1:8001 WINCHESTER RD
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38125-2204
Practice Address - Country:US
Practice Address - Phone:901-309-1455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-25
Last Update Date:2020-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN41567183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist