Angela R Clevenger, DOCTOR OF PHARMACY

Individual provider Active NPI Pharmacist · Ashdown, AR

NPI 1811337207 · NPPES record last updated Jun 28, 2013

Key facts

NPI
1811337207
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
PD08533 (AR)
Practice address
191 W Main St
Ashdown, AR 71822-2714
Phone
(870) 898-5151
Fax
(870) 898-2395
NPI assigned
Jun 28, 2013
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

LicenseStateTypeSpecialty
PD08533ARMDPharmacist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PD08533 AR Yes

Addresses

Primary practice location

191 W Main St
Ashdown, AR 71822-2714

Mailing address

191 W Main St
Ashdown, AR 71822-2714
Phone (870) 898-5151

Other providers in Ashdown, AR

All providers in Ashdown, AR · Pharmacist in Arkansas

Sources for this page

Verify at the official NPI Registry.