Marquivia D Clark, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

19157 Issued in AL

Practice address

4240 Narrow Lane Rd
Montgomery, AL 36111-2650

Phone

(334) 284-3298

Fax

(334) 284-3816

NPI assigned

Dec 7, 2020

Last updated

Dec 7, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Alabama CVS Pharmacy. L.L.C.

  dba CVS Pharmacy #04906

  • Pharmacy
  • Montgomery, AL
  • NPI 1225131949
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1607299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607299200000",
    "number": "1598361479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4240 NARROW LANE RD",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361112650",
            "telephone_number": "334-284-3298",
            "fax_number": "334-284-3816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4240 NARROW LANE RD",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361112650",
            "telephone_number": "334-284-3298",
            "fax_number": "334-284-3816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "MARQUIVIA",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-07",
        "last_updated": "2020-12-07",
        "certification_date": "2020-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AL",
            "license": "19157",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALBOP",
            "identifier": "19157",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gyllane Clark
• James Allen Clark III, M.D.
• Jeffrey S Clark, COUNSELOR
• Latoya Shantel Clark, MD
• Lori Johnson Clark, R.PH
• Mary L Clark, MS, LPC
• Nellda C Clark, CRNP
• Susan Noble Clark
• Claudias Place Inc. (N/a)
• Jeremy Alonzo Clausell

• Pharmacist in Montgomery, AL
• Providers in Montgomery, AL by specialty
• Pharmacist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.