Provider Demographics
NPI:1013093905
Name:MCCLANAHAN, RONDAL CASE (RPH)
Entity Type:Individual
Prefix:MR
First Name:RONDAL
Middle Name:CASE
Last Name:MCCLANAHAN
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 1:7855 MOFFETT RD
Mailing Address - Street 2:
Mailing Address - City:SEMMES
Mailing Address - State:AL
Mailing Address - Zip Code:36575-5411
Mailing Address - Country:US
Mailing Address - Phone:251-645-8184
Mailing Address - Fax:
Practice Address - Street 1:7855 MOFFETT RD
Practice Address - Street 2:
Practice Address - City:SEMMES
Practice Address - State:AL
Practice Address - Zip Code:36575-5411
Practice Address - Country:US
Practice Address - Phone:251-645-8184
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2009-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL12237183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist