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NPI Code Detail

MEDICARE: MRS. AMANDA REAVES CLAYTON RPH

MEDICARE:  MRS. AMANDA REAVES CLAYTON  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
1183500000XPharmacist11822NC

General Provider Information

NPI Number : 1568693513
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. AMANDA REAVES CLAYTON RPH
Provider Business Mailing Address
First Line : 533 HOLLY SPRINGS DR
Second Line :
City : TIMBERLAKE
State : NC
Zip : 27583-8681
Country : US
Telephone Number : 336-364-1021
Fax Number : 336-599-5076
Provider Business Practice Location Address
First Line : 304 N MADISON BLVD
Second Line :
City : ROXBORO
State : NC
Zip : 27573-5355
Country : US
Telephone Number : 336-599-0234
Fax Number : 336-599-5076
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/06/2009
Last Update Date : 08/06/2009

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Directions to “ MRS. AMANDA REAVES CLAYTON RPH” Practice Location

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