Healthcare Provider Details

I. General information

NPI: 1205835113
Provider Name (Legal Business Name): MELVIN CLAVER RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 07/21/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

270 GEIGER RD SUITE F
PHILADELPHIA PA
19115-1016
US

IV. Provider business mailing address

1613 HAMPTON RD
HAVERTOWN PA
19083-2505
US

V. Phone/Fax

Practice location:
  • Phone: 215-464-7304
  • Fax: 215-464-7308
Mailing address:
  • Phone: 610-449-2732
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP020845L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: