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General NPI Number Information
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NPI Number | 1568693513
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Entity Type | Individual
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Provider Name | AMANDA REAVES CLAYTON RPH
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Gender | Female
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Dates
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Enumeration Date | 08/06/2009
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Last Update Date | 08/06/2009
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Provider Practice Location Address
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Address Line | 304 N MADISON BLVD
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City | ROXBORO
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State | NC
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Zip | 27573-5355
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Country | US
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Telephone | 336-599-0234
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Fax | 336-599-5076
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Provider Business Mailing Address
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Address Line | 533 HOLLY SPRINGS DR
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City | TIMBERLAKE
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State | NC
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Zip | 27583-8681
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Country | US
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Telephone | 336-364-1021
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Fax | 336-599-5076
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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 | 11822
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License Number State | NC
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