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General NPI Number Information
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NPI Number | 1477890978
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Entity Type | Individual
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Provider Name | BENJAMIN JOSEPH CLOUD PHARM D.
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Gender | Male
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Dates
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Enumeration Date | 01/04/2013
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Last Update Date | 01/04/2013
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Provider Practice Location Address
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Address Line | 208 CIBCUE CIRCLE
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City | SAN CARLOS
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State | AZ
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Zip | 85550-0208
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Country | US
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Telephone | 928-475-7269
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 208
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City | SAN CARLOS
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State | AZ
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Zip | 85550-0208
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Country | US
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Telephone | 928-475-7269
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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 | 1835G0303X
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Taxonomy Name | Geriatric Pharmacist
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License Number | 2011037526
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | 2011037526
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License Number State | MO
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