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General NPI Number Information
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NPI Number | 1679846679
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Entity Type | Individual
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Provider Name | TRACY CLAPP PHARMD
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Gender | Female
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Dates
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Enumeration Date | 02/22/2012
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Last Update Date | 02/22/2012
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Provider Practice Location Address
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Address Line | 975 BACONS BRIDGE RD UNIT 117
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City | SUMMERVILLE
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State | SC
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Zip | 29485-4189
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Country | US
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Telephone | 843-871-0043
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Fax |
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Provider Business Mailing Address
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Address Line | 179 VACUUM LN
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City | RIDGEVILLE
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State | SC
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Zip | 29472-8272
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Country | US
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Telephone | 843-568-9079
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 11969
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License Number State | SC
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