Provider Demographics
NPI:1891271037
Name:MCCLUNG, ENID CHRISTINE (RPH)
Entity Type:Individual
Prefix:
First Name:ENID
Middle Name:CHRISTINE
Last Name:MCCLUNG
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3907 OLD WILLIAM PENN HWY
Mailing Address - Street 2:
Mailing Address - City:MURRYSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15668-1833
Mailing Address - Country:US
Mailing Address - Phone:724-327-6611
Mailing Address - Fax:724-327-5814
Practice Address - Street 1:3907 OLD WILLIAM PENN HWY
Practice Address - Street 2:
Practice Address - City:MURRYSVILLE
Practice Address - State:PA
Practice Address - Zip Code:15668-1833
Practice Address - Country:US
Practice Address - Phone:724-327-6611
Practice Address - Fax:724-327-5814
Is Sole Proprietor?:No
Enumeration Date:2018-07-11
Last Update Date:2018-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP035405L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PARP035405LOtherSTATE