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NPI Code Detail

MEDICARE: EBONI CHARICE MCCLAIN PHARM D

MEDICARE: EBONI CHARICE MCCLAIN PHARM D
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
1183500000XPharmacist0202216031VA

General Provider Information

NPI Number : 1861916322
Entity Type Code : Individual
Provider Name (Legal Business Name) : EBONI CHARICE MCCLAIN PHARM D
Provider Business Mailing Address
First Line : 248 COVENTRY CLOSE APT 204
Second Line :
City : CHESAPEAKE
State : VA
Zip : 23320-4661
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7601 GRANBY ST
Second Line :
City : NORFOLK
State : VA
Zip : 23505-2508
Country : US
Telephone Number : 757-489-1157
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/26/2017
Last Update Date : 07/26/2017

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Directions to “ EBONI CHARICE MCCLAIN PHARM D” Practice Location

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