Provider Demographics
NPI:1013459650
Name:MCGLONE, CHRISTOPHER BRUCE (RPH)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:BRUCE
Last Name:MCGLONE
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 1:89 SECOND ST
Mailing Address - Street 2:
Mailing Address - City:VANCEBURG
Mailing Address - State:KY
Mailing Address - Zip Code:41179-5439
Mailing Address - Country:US
Mailing Address - Phone:606-796-2932
Mailing Address - Fax:606-796-2124
Practice Address - Street 1:89 SECOND ST
Practice Address - Street 2:
Practice Address - City:VANCEBURG
Practice Address - State:KY
Practice Address - Zip Code:41179-5439
Practice Address - Country:US
Practice Address - Phone:606-796-2932
Practice Address - Fax:606-796-2124
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-14
Last Update Date:2016-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY009382183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY009382OtherKENTUCKY BOARD OF PHARMACY
OH03116293OtherOHIO BOARD OF PHARMACY