Healthcare Provider Details

I. General information

NPI: 1114893153
Provider Name (Legal Business Name): DUSTIN PIERCE CLARK PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/16/2025
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

430 FISHER CREEK RD
SYLVA NC
28779-7700
US

IV. Provider business mailing address

430 FISHER CREEK RD
SYLVA NC
28779-7700
US

V. Phone/Fax

Practice location:
  • Phone: 828-586-4012
  • Fax: 828-586-5162
Mailing address:
  • Phone: 828-586-4012
  • Fax: 828-586-5162

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number700637
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number22923
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: