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NPI 1811219264

NPI 1811219264 : ADAM CLARKE R.PH. : PENSACOLA, FL

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General NPI Number Information
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    NPI Number           |    1811219264
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    Entity Type          |    Individual 
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    Provider Name        |    ADAM CLARKE R.PH.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    02/25/2010
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    Last Update Date     |    02/25/2010
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Provider Practice Location Address
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    Address Line         |    235 E NINE MILE RD 
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    City                 |    PENSACOLA
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    State                |    FL
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    Zip                  |    32534-3150
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    Country              |    US
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    Telephone            |    850-484-7554
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    Fax                  |    850-478-9759
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Provider Business Mailing Address
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    Address Line         |    235 E NINE MILE RD 
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    City                 |    PENSACOLA
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    State                |    FL
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    Zip                  |    32534-3150
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    Country              |    US
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    Telephone            |    850-484-7554
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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       |    PS38527
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    License Number State |    FL
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