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General NPI Number Information
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NPI Number | 1992524854
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Entity Type | Individual
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Provider Name | SHAYNA MCCLURE PHARMD
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Gender | Female
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Dates
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Enumeration Date | 10/08/2024
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Last Update Date | 10/08/2024
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Provider Practice Location Address
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Address Line | 4300 PACES FERRY RD SE STE 170
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City | ATLANTA
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State | GA
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Zip | 30339-5705
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Country | US
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Telephone | 770-433-9437
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Fax |
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Provider Business Mailing Address
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Address Line | 3743 GARDENWICK RD
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City | POWDER SPRINGS
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State | GA
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Zip | 30127-5668
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Country | US
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Telephone | 404-938-3357
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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 | RPH035117
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License Number State | GA
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