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General NPI Number Information
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NPI Number | 1720424120
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Entity Type | Individual
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Provider Name | DOUGLAS MCLASKEY
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Gender | Male
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Dates
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Enumeration Date | 05/13/2013
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Last Update Date | 05/13/2013
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Provider Practice Location Address
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Address Line | 1403 INYO ST APT 19
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City | CRESCENT CITY
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State | CA
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Zip | 95531-2146
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Country | US
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Telephone | 208-867-5310
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 759
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City | CRESCENT CITY
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State | CA
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Zip | 95531-0759
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Country | US
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Telephone | 208-867-5310
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Fax |
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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 | 68411
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License Number State | CA
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