Provider Demographics
NPI:1063513273
Name:MCNEILL, CLARICE M (RPH, CGP,FASCP)
Entity type:Individual
Prefix:
First Name:CLARICE
Middle Name:M
Last Name:MCNEILL
Suffix:
Gender:F
Credentials:RPH, CGP,FASCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3366 PARFOURE BLVD
Mailing Address - Street 2:
Mailing Address - City:UNIONTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44685-7827
Mailing Address - Country:US
Mailing Address - Phone:330-699-1895
Mailing Address - Fax:
Practice Address - Street 1:3366 PARFOURE BLVD
Practice Address - Street 2:
Practice Address - City:UNIONTOWN
Practice Address - State:OH
Practice Address - Zip Code:44685-7827
Practice Address - Country:US
Practice Address - Phone:330-699-1895
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-2-13941183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist