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General NPI Number Information
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NPI Number | 1528081718
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Entity Type | Organization
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Legal Business Name | CLARKE-SMITH PHARMACY INC
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Dates
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Enumeration Date | 07/26/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 227 NORTH MAIN STREET
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City | LAWRENCEVILLE
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State | VA
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Zip | 23868
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Country | US
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Telephone | 434-848-2340
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Fax | 434-848-0683
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Provider Business Mailing Address
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Address Line | 227 NORTH MAIN STREET
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City | LAWRENCEVILLE
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State | VA
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Zip | 23868
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Country | US
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Telephone | 434-848-2340
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Fax | 434-848-0683
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Authorized Official
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Title or Position | PRESIDENT PHARMACIST IN CHARGE
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Name | MR. KEITH WEATHERS CLARKE
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Credential | RPH
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Telephone | 434-848-2340
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 0201001422
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License Number State | VA
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