Kenneth R Clark is a Pharmacist in Pascagoula, Mississippi. Kenneth R Clark practices all healthcare services and medical treatments related to Pharmacist. The NPI Number for Kenneth R Clark is 1821119959. The last update date is 2017-11-15.
Kenneth R Clark's current location address is 4211 Hospital St Ste 104, Pascagoula, Mississippi. You can contact this provider via phone number 2287621940 and fax number 2287627786. The mailing address for Kenneth R Clark is 4211 Hospital St Ste 104, Pascagoula, Mississippi. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Kenneth R Clark |
|---|---|
| Address | 4211 Hospital St Ste 104, Pascagoula, Mississippi |
| Phone Number | 2287621940 |
| Fax Number | 2287627786 |
| Sole Proprietor | Y |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1821119959 |
|---|---|
| Provider Enumeration Date | 2007-04-03 |
| Last Updated Date | 2017-11-15 |
Provider Mailing Address Detail
| Address | 4211 Hospital St Ste 104 |
|---|---|
| City | Pascagoula |
| State | Mississippi (MS) |
| Post Code | 395815310 |
| Phone Number | 2287621940 |
| Fax Number | 2287627786 |
Provider's Primary Taxonomy Detail
| Speciality | Pharmacist |
|---|---|
| Taxonomy | 183500000X |
| Licence No | E-06773 |
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Definition: An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or m |
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Post Comment/ Review Below
What is the unique identifier code issued to Kenneth R Clark by the Centers for Medicare & Medicaid Services?
The Kenneth R Clark has been assigned the NPI (National Provider Identifier) 1821119959. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Could you share the physical location details of Kenneth R Clark?
The Kenneth R Clark is situated at 4211 Hospital St Ste 104, in the city of Pascagoula, state of MS, with the zip code 395815310.
What is Kenneth R Clark's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for Kenneth R Clark is Pharmacist, and the taxonomy classification code that categorizes this area of expertise is 183500000X.
On what date did the Centers for Medicare & Medicaid Services issue the 1821119959 to Kenneth R Clark?
The Kenneth R Clark received its 1821119959 assignment from the Centers for Medicare & Medicaid Services on 2007-04-03.
When was the information regarding Kenneth R Clark, such as address, specialty, and other details, most recently verified or confirmed to be accurate?
The information pertaining to Kenneth R Clark, including its address, specialty, and other relevant details, was most recently verified or confirmed to be accurate on 2017-11-15.
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