Provider Demographics
NPI:1962782623
Name:MCLANE, JOSEPH M (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:M
Last Name:MCLANE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:735 N WATER ST
Mailing Address - Street 2:
Mailing Address - City:UHRICHSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44683-1455
Mailing Address - Country:US
Mailing Address - Phone:740-922-7587
Mailing Address - Fax:
Practice Address - Street 1:735 N WATER ST
Practice Address - Street 2:
Practice Address - City:UHRICHSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44683-1455
Practice Address - Country:US
Practice Address - Phone:740-922-7587
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-25
Last Update Date:2011-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRPH.03331372-3183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist