Individual
DESSIE CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
261 PRIVATE LN, NASHVILLE, NC 27856-8114
(252) 937-2284
Mailing address
261 PRIVATE LN, NASHVILLE, NC 27856-8114
(252) 937-2284
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
6893
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11021979
MEDICARE
NC
Enumeration date
10/31/2014
Last updated
10/31/2014
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