Provider Demographics
NPI:1366475717
Name:MCCLUNG, CAR DOUGLAS (PHARMACIST)
Entity type:Individual
Prefix:MR
First Name:CAR
Middle Name:DOUGLAS
Last Name:MCCLUNG
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 HASTINGS RD
Mailing Address - Street 2:
Mailing Address - City:MARLBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:07746-1354
Mailing Address - Country:US
Mailing Address - Phone:732-536-2183
Mailing Address - Fax:
Practice Address - Street 1:25 HASTINGS RD
Practice Address - Street 2:
Practice Address - City:MARLBORO
Practice Address - State:NJ
Practice Address - Zip Code:07746-1354
Practice Address - Country:US
Practice Address - Phone:732-536-2183
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY26894183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist