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General NPI Number Information
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NPI Number | 1639766256
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Entity Type | Individual
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Provider Name | TARA ELIZABETH CLARKE
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Gender | Female
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Dates
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Enumeration Date | 12/29/2020
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Last Update Date | 12/29/2020
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Provider Practice Location Address
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Address Line | 1050 BRANDYWINE PKWY
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City | WILMINGTON
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State | DE
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Zip | 19803-1492
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Country | US
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Telephone | 302-478-3200
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Fax |
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Provider Business Mailing Address
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Address Line | 2325 KATHERINE AVE
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City | WILMINGTON
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State | DE
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Zip | 19808-4625
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Country | US
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Telephone | 302-753-2512
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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 | 183700000X
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Taxonomy Name | Pharmacy Technician
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License Number |
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License Number State |
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