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General NPI Number Information
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NPI Number | 1073632535
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Entity Type | Individual
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Provider Name | TARA BETH MCCLOUD PHARM D
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Gender | Female
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Dates
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Enumeration Date | 03/28/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 12544 US ROUTE 60
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City | ASHLAND
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State | KY
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Zip | 41102-9687
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Country | US
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Telephone | 606-475-0232
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Fax | 606-475-0254
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Provider Business Mailing Address
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Address Line | 84 WOODCREST RD
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City | GRAYSON
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State | KY
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Zip | 41143-1933
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Country | US
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Telephone | 606-475-1016
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Fax | 606-474-0648
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 012986
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License Number State | KY
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