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General NPI Number Information
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NPI Number | 1326525098
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Entity Type | Individual
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Provider Name | SLATER CLARK NASH JR. RPH
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Gender | Male
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Dates
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Enumeration Date | 07/25/2018
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Last Update Date | 10/24/2019
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Provider Practice Location Address
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Address Line | 2165 BRYTON DR
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City | POWELL
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State | OH
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Zip | 43065-9198
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Country | US
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Telephone | 614-581-7935
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Fax |
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Provider Business Mailing Address
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Address Line | 7900 E ARROWHEAD PKWY APT 344
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City | SIOUX FALLS
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State | SD
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Zip | 57110-7021
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Country | US
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Telephone | 614-581-7935
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1835N1003X
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Taxonomy Name | Nutrition Support Pharmacist
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License Number | 03216503
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 03216503
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License Number State | OH
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