Rebecca Clarke
Individual provider Active NPI Pharmacist · Freedom, PA
NPI 1669907465 · NPPES record last updated Apr 29, 2017
Key facts
- NPI
- 1669907465
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- RP449099 (PA)
- Practice address
- 2500 Lovi Rd
Freedom, PA 15042-9398 - Phone
- (412) 203-1444
- NPI assigned
- Apr 29, 2017
- 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 03135265 | OH | MD | Pharmacist |
| RP449099 | PA | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RP449099 | PA | Yes |
| Pharmacist | 183500000X | 03135265 | OH |
Addresses
Primary practice location
2500 Lovi Rd
Freedom, PA 15042-9398
Mailing address
29 Fairlawn Ave
Boardman, OH 44512-1506
Other providers in Freedom, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 29, 2017. 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.