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General NPI Number Information
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NPI Number | 1417184755
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Entity Type | Individual
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Provider Name | CLYDE GORDON EURE RPH
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Gender | Male
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Dates
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Enumeration Date | 06/13/2009
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Last Update Date | 06/13/2009
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Provider Practice Location Address
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Address Line | 1901 N CROATAN HWY
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City | KILL DEVIL HILLS
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State | NC
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Zip | 27948-8978
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Country | US
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Telephone | 252-441-2001
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Fax | 252-449-0320
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Provider Business Mailing Address
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Address Line | 1901 N CROATAN HWY
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City | KILL DEVIL HILLS
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State | NC
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Zip | 27948-8978
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Country | US
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Telephone | 252-441-2001
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Fax | 252-449-0320
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 10905
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License Number State | NC
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