MEDICARE: LYNN CLARK RPH

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	34339	TX
2	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	34339	TX

General Provider Information

NPI Number	:	1346688546
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LYNN CLARK RPH

Provider Business Mailing Address
First Line	:	PO BOX 765311
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75376-5311
Country	:	US
Telephone Number	:	972-998-6901
Fax Number	:

Provider Business Practice Location Address
First Line	:	400 N SAINT PAUL ST STE 1205
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75201-6869
Country	:	US
Telephone Number	:	855-994-0100
Fax Number	:	972-803-6626

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

Provider Enumeration Date	:	06/10/2013
Last Update Date	:	12/13/2022

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Directions to “ LYNN CLARK RPH” Practice Location

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