MEDICARE: MACHELL BELL CLARK

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	3747P1801X	Personal Care Attendant		NC

General Provider Information

NPI Number	:	1790011542
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MACHELL BELL CLARK

Provider Business Mailing Address
First Line	:	3011 S MEMORIAL DR
Second Line	:
City	:	GREENVILLE
State	:	NC
Zip	:	27834-6238
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3011 S MEMORIAL DR
Second Line	:	SUITE 7
City	:	GREENVILLE
State	:	NC
Zip	:	27834-6238
Country	:	US
Telephone Number	:	252-327-3705
Fax Number	:	252-364-1534

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

Provider Enumeration Date	:	10/29/2009
Last Update Date	:	10/29/2009

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Directions to “ MACHELL BELL CLARK ” Practice Location

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