MEDICARE: JESSICA MCCLUNG

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	PS63164	FL

General Provider Information

NPI Number	:	1578232062
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA MCCLUNG

Provider Business Mailing Address
First Line	:	2204 CROOKED OAK CT
Second Line	:
City	:	PANAMA CITY BEACH
State	:	FL
Zip	:	32408-5715
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2533 THOMAS DR
Second Line	:
City	:	PANAMA CITY BEACH
State	:	FL
Zip	:	32408-6252
Country	:	US
Telephone Number	:	850-235-3200
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/08/2021
Last Update Date	:	09/08/2021

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Directions to “ JESSICA MCCLUNG ” Practice Location

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