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NPI Code Detail

MEDICARE: DR. MARK CLAYTON PRICE PHARM.D.

MEDICARE: DR. MARK CLAYTON PRICE PHARM.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist22879NC

General Provider Information

NPI Number : 1811245046
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARK CLAYTON PRICE PHARM.D.
Provider Business Mailing Address
First Line : 3922 PUETTS CHAPEL RD
Second Line :
City : DALLAS
State : NC
Zip : 28034-8734
Country : US
Telephone Number : 276-782-0046
Fax Number :
Provider Business Practice Location Address
First Line : 500 W CHURCH ST
Second Line :
City : CHERRYVILLE
State : NC
Zip : 28021-2812
Country : US
Telephone Number : 704-435-5082
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/20/2012
Last Update Date : 08/20/2012

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