Provider Demographics
NPI:1134728652
Name:MCLEAN, ANSLEY JASPER (PHARMD)
Entity type:Individual
Prefix:
First Name:ANSLEY
Middle Name:JASPER
Last Name:MCLEAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:ANSLEY
Other - Middle Name:JASPER
Other - Last Name:MOORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:327 SKYLAND DR
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:SC
Mailing Address - Zip Code:29325-5353
Mailing Address - Country:US
Mailing Address - Phone:229-873-0916
Mailing Address - Fax:
Practice Address - Street 1:701 GROVE RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29605-4210
Practice Address - Country:US
Practice Address - Phone:864-455-8815
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-26
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC42110183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist