Provider Demographics
NPI:1184172959
Name:MCCLAIN, WILLIAM KEITH (RPH)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:KEITH
Last Name:MCCLAIN
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 1:4601 US HIGHWAY 220 N
Mailing Address - Street 2:
Mailing Address - City:SUMMERFIELD
Mailing Address - State:NC
Mailing Address - Zip Code:27358-9207
Mailing Address - Country:US
Mailing Address - Phone:336-643-7738
Mailing Address - Fax:
Practice Address - Street 1:6920 WOODEN RAIL LN
Practice Address - Street 2:
Practice Address - City:SUMMERFIELD
Practice Address - State:NC
Practice Address - Zip Code:27358-9219
Practice Address - Country:US
Practice Address - Phone:336-312-6720
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-21
Last Update Date:2016-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC07819183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist