Provider Demographics
NPI:1386799716
Name:MCCLURE DRUGS INC
Entity type:Organization
Organization Name:MCCLURE DRUGS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:WARREN
Authorized Official - Last Name:TONEY
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:812-283-7941
Mailing Address - Street 1:627 EASTERN BLVD
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47129-2453
Mailing Address - Country:US
Mailing Address - Phone:812-283-7941
Mailing Address - Fax:812-283-0459
Practice Address - Street 1:627 EASTERN BLVD
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47129-2453
Practice Address - Country:US
Practice Address - Phone:812-283-7941
Practice Address - Fax:812-283-0459
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2008-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26016084183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100278420Medicaid