Ryan Manning Clements
Individual provider Active NPI Pharmacist · Kingsland, GA
NPI 1326385162 · NPPES record last updated Jan 14, 2013
Key facts
- NPI
- 1326385162
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 025054 (GA)
- Practice address
- 1601 Hwy 40 E
Kingsland, GA 31548-6500 - Phone
- (912) 729-1457
- NPI assigned
- Jan 14, 2013
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 025054 | GA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Woodbine Medical, LLC | Current | Accepting new patients | |
| Woodbine Medical, LLC | Current | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 025054 | GA | Yes |
Addresses
Primary practice location
1601 Hwy 40 E
Kingsland, GA 31548-6500
Mailing address
1601 Hwy 40 E
Kingsland, GA 31548-6500
Other providers in Kingsland, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 14, 2013. 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.