Provider Demographics
NPI:1841582889
Name:MCLAWHORN, DESIREE MENDOZA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:DESIREE
Middle Name:MENDOZA
Last Name:MCLAWHORN
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 1:14520 JOHN REX BLVD
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27614-8592
Mailing Address - Country:US
Mailing Address - Phone:919-556-2434
Mailing Address - Fax:919-562-4669
Practice Address - Street 1:14520 JOHN REX BLVD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27614-8592
Practice Address - Country:US
Practice Address - Phone:919-556-2434
Practice Address - Fax:919-562-4669
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-10
Last Update Date:2011-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC17700183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist