MEDICARE: WILLIAM CLARENCE EARP 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	27883	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	27883	OTHER	TX	TX STATE BOARD OF PHARMACY RPH LICENSE NUMBER

General Provider Information

NPI Number	:	1497228902
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM CLARENCE EARP RPH

Provider Business Mailing Address
First Line	:	3289 COUNTY ROAD 268
Second Line	:
City	:	BAIRD
State	:	TX
Zip	:	79504-4134
Country	:	US
Telephone Number	:	972-900-9912
Fax Number	:

Provider Business Practice Location Address
First Line	:	312 S COMMERCIAL AVE
Second Line	:
City	:	COLEMAN
State	:	TX
Zip	:	76834-4214
Country	:	US
Telephone Number	:	325-625-2178
Fax Number	:	325-625-3056

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

Provider Enumeration Date	:	01/07/2019
Last Update Date	:	01/07/2019

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