KELVIN CLARK (NPI# 1093168452) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093168452 |
| Entity Type | Individual |
| Full Name | KELVIN CLARK |
| Practice Address |
4712 Bass Dr Holly Hill SC 29059-8812 |
| Practice Telephone | 8038579363 |
| Practice Fax Number | 8034929305 |
| Enumeration Date | 2016-07-20 |
| Last Update Date | 2016-07-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 172A00000X | Driver | 100636369 | SC | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033165923 | Kelvin D Clark | Counselor | 1500 Bragg Blvd, Fayetteville, NC 28301-4289 | 2006-05-25 |
| Street Address |
4712 BASS DR |
| City | HOLLY HILL |
| State | SC |
| Zip Code | 29059-8812 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376918979 | Community Organization for Rights and Empowerment | Voluntary or Charitable | 1250 Unity Road, Holly Hill, SC 29059 | 2015-12-08 |
| 1518351139 | Holly Street Drugs, LLC | Pharmacy | 904 Holly Street, Holly Hill, SC 29059 | 2015-03-20 |
| 1710310735 | Troy Blakely Lamb | Pharmacist | 8530 Old State Rd., Holly Hill, SC 29059 | 2013-08-13 |
| 1861742231 | Michael James Myers | Pharmacist | 8523 Old State Road, Holly Hill, SC 29059 | 2012-09-13 |
| 1215208822 | Robert Rodelsperger Dmd Pa | Dentist | 912 Holly St, Holly Hill, SC 29059 | 2012-01-13 |
| 1053624262 | Stephanie R Jamison | Counselor | 421 Gardener Boulevard, Holly Hill, SC 29059 | 2010-07-16 |
| 1619158771 | Adams Optical Dba Holly Hill Eye Clinic | Optometrist | 190 Rental Dr., Holly Hill, SC 29059 | 2007-11-16 |
| 1780736710 | Total Comfort Adult Daycare | Home Health | 1706 Camden Rd, Holly Hill, SC 29059 | 2007-01-18 |
| 1255490314 | South Carolina Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 8523 Old State Rd, Holly Hill, SC 29059 | 2006-12-06 |
| 1881797900 | Chucks Pharmacy Inc | Pharmacy | 904 Holly St, Holly Hill, SC 29059 | 2006-09-06 |
| Find all providers in zip 29059 | ||||
| Taxonomy Code | 172A00000X |
| Grouping | Other Service Providers |
| Classification | Driver |
| A person employed to operate a motor vehicle as a carrier of persons or property. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962012641 | Sally Allen | Driver | 136 Fields Street, Varnville, SC 29944-2994 | 2020-08-06 |
| 1659997633 | Anthony Murray | Driver | 119 Stoney Creek Way, Moncks Corner, SC 29461-7381 | 2020-06-24 |
| 1558986372 | Shakelia Fogle | Driver | 212 Frankfort Ct, Eutawville, SC 29048-9107 | 2020-06-09 |
| 1962024422 | Monica Miller | Driver | 1313 Hunter Dr, Barnwell, SC 29812-6773 | 2020-05-07 |
| 1205478047 | Elicef Benita Francis | Driver | 417 Jefferies Ln Apt 8, Florence, SC 29505-2278 | 2019-10-14 |
| 1356983225 | Ricky Ricardo Garner | Driver | 1613 Lower Richland Blvd, Hopkins, SC 29061-8631 | 2019-10-11 |
| 1881154979 | Jada Atkins | Driver | 320 Spruce St Apt 2a, Spartanburg, SC 29303-3901 | 2019-03-23 |
| 1831674878 | Jackeya Whitten | Driver | 560 Eutaw Hwy, Eutawville, SC 29048-9037 | 2018-09-25 |
| 1740767987 | Bryant Lawson | Driver | 2266 Saint Paul Rd, Summerton, SC 29148-7021 | 2018-07-20 |
| 1477049484 | Adebambo Adesanya | Driver | 1008 Turtle Dove Ln, Ladson, SC 29456 | 2018-07-03 |
| Find all providers with the same taxonomy | ||||
| City | HOLLY HILL |
| Zip Code | 29059 |
Please comment or provide details below to improve the information on KELVIN CLARK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.