Chelsey Clark
Individual provider Active NPI Pharmacist · Troy, MO
NPI 1609477017 · NPPES record last updated Nov 3, 2020
Key facts
- NPI
- 1609477017
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 2018029988 (MO)
- Practice address
- 101 Highway 47 E
Troy, MO 63379-3100 - Phone
- (636) 462-6366
- NPI assigned
- Nov 3, 2020
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|
| 2018029988 | MO | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 2018029988 | MO | Yes |
Addresses
Primary practice location
101 Highway 47 E
Troy, MO 63379-3100
Mailing address
101 Highway 47 E
Troy, MO 63379-3100
Other providers in Troy, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 3, 2020. 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.