Individual
VIRGINIA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13660 CALIFORNIA ST, OMAHA, NE 68154-5233
(800) 546-5677
(866) 632-7946
Mailing address
13660 CALIFORNIA ST, OMAHA, NE 68154-5233
(800) 546-5677
(866) 632-7946
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
N7B9K7Q7
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
N7B9K7Q7
CPHT
NE
Enumeration date
08/06/2014
Last updated
08/06/2014
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