Vanessa Clark, PHARMD
Individual provider Active NPI Pharmacist · Sandersville, GA
NPI 1003363946 · NPPES record last updated Sep 8, 2016
Key facts
- NPI
- 1003363946
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- RPH026654 (GA)
- Practice address
- 1308 S Harris St
Sandersville, GA 31082-6913 - Phone
- (478) 552-7063
- Fax
- (478) 553-0939
- NPI assigned
- Sep 8, 2016
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPH026654 | GA | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH026654 | GA | Yes |
Addresses
Primary practice location
1308 S Harris St
Sandersville, GA 31082-6913
Mailing address
1308 S Harris St
Sandersville, GA 31082-6913
Phone (478) 552-7063
Other providers in Sandersville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 8, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.