BENJAMIN ADDRIL CLARK (NPI# 1548750110) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548750110 |
| Entity Type | Individual |
| Full Name | BENJAMIN ADDRIL CLARK |
| Credential | RPH |
| Practice Address |
Se Regional Pharmacy Attn: Ben Clark 300 First Avenue South Reidsville GA 30453 |
| Practice Telephone | 9125577960 |
| Practice Fax Number | 9125577975 |
| Enumeration Date | 2018-05-18 |
| Last Update Date | 2018-05-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | RPH016066 | GA | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285189704 | Benjamin Clark | Physical Therapist | 4501 Main St Ste 5, Shallotte, NC 28470-4585 | 2016-08-25 |
| 1275931479 | Benjamin Brian Clark | Physical Therapist | 7909 Forrest Ave, Belton, MO 64012-5303 | 2014-12-22 |
| 1831400894 | Benjamin T Clark | Family Medicine | 35945 N Gary Rd, San Tan Valley, AZ 85143-5748 | 2010-06-24 |
| 1497708572 | Benjamin S Clark | Nurse Practitioner | 1861 Main Street, Sneedville, TN 37869 | 2006-05-18 |
| 1598743627 | Benjamin Todd Clark | Dentist | 52 Medical Group, Unit 3690, Apo, AE 09126 | 2006-01-09 |
| 1730680232 | Benjamin Jonah Clark | Case Manager/Care Coordinator | 344 E 100 S Ste 301, Salt Lake City, UT 84111-1727 | 2018-02-21 |
| 1851773196 | Benjamin Clark | General Practice | 3288 Moanalua Rd, Honolulu, HI 96819 | 2015-06-23 |
| 1699180448 | Benjamin Allen Clark | Dentist | 1220 N Washington Ave, Durant, OK 74701-2120 | 2014-06-30 |
| 1790105674 | Benjamin Joseph Clark | Internal Medicine | 6431 Fannin St, Houston, TX 77030-1501 | 2014-04-18 |
| 1326321811 | Benjamin Paul Clark | Pharmacist | 2318 Frederica St, Owensboro, KY 42301-4826 | 2011-09-21 |
| Street Address |
SE REGIONAL PHARMACY ATTN: BEN CLARK 300 FIRST AVENUE SOUTH |
| City | REIDSVILLE |
| State | GA |
| Zip Code | 30453 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659990869 | Katrina A Toler | Specialist/Technologist, Other | Optim Medical Center - Tattnall, 247 S Main Street, Reidsville, GA 30453 | 2020-04-09 |
| 1770824351 | Elite Care Dme,llc | Durable Medical Equipment & Medical Supplies | 123 S. Main St., Reidsville, GA 30453 | 2013-03-07 |
| 1003154766 | Rebekah Hollis Parker | Occupational Therapist | 247 A South Main Street, Reidsville, GA 30453 | 2013-01-30 |
| 1629359419 | D. Wilson Inc. | Durable Medical Equipment & Medical Supplies | 121 South Main Street Unit A, Reidsville, GA 30453 | 2011-09-07 |
| 1417278029 | Tattnall Community Ems | Ambulance | 194 John O Parker Dr., Reidsville, GA 30453 | 2010-06-17 |
| 1518122563 | Brenda Marie Black | Licensed Practical Nurse | 150 Memorial Drive, 150 Memorial Drive, Reidsville, GA 30453 | 2008-07-18 |
| 1063694404 | Ihori Kameyama | Counselor | 150 Memorial Dr., Reidsville, GA 30453 | 2007-11-28 |
| 1710947403 | Donald Franklin Kennedy Jr. | Specialist | 131 Memorial Drive, Reidsville, GA 30453 | 2006-03-25 |
| 1801438676 | Olive Care Durable Medical & Supplies, LLC. | Durable Medical Equipment & Medical Supplies | 123 S. Main St., Reidsville, GA 30453 | 2019-10-14 |
| 1932489481 | Natalie Pippin Britt | Emergency Medicine | 247 S Main St, Reidsville, GA 30453 | 2011-08-27 |
| Find all providers in zip 30453 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558638536 | Tracey Caroline Cook | Pharmacist | 1623 Way, Reidsville, NC 27320 | 2011-11-19 |
| 1306130075 | Michelle Renee Gregory | Pharmacist | 1615 Way St, Reidsville, NC 27320-5748 | 2011-05-30 |
| 1871815688 | Richard William Raspet | Pharmacist | 1623 Way St, Reidsville, NC 27320-5748 | 2010-02-20 |
| 1104986710 | Reidsville Pharmacy Inc | Pharmacist | 924 S Scales St, Reidsville, NC 27320-5318 | 2006-12-12 |
| 1184722860 | Frank Danny Toole | Pharmacist | 214 South Main Street, Reidsville, GA 30453-0159 | 2006-09-20 |
| 1174187900 | James Scott Baker | Pharmacist | 726 S Scales St, Reidsville, NC 27320-5330 | 2019-04-26 |
| 1609225838 | Chase Caligiure | Pharmacist | 1607 Way St, Reidsville, NC 27320-5748 | 2016-06-08 |
| 1962810325 | Shannon Lowe | Pharmacist | 603 S Scales St, Reidsville, NC 27320-5023 | 2014-07-30 |
| 1962815548 | Collin Wofford Runyon | Pharmacist | 219 Gilmer St, Reidsville, NC 27320-3809 | 2014-06-11 |
| 1346651809 | Cassandra Widener | Pharmacist | 1624 Nc Highway 14, Reidsville, NC 27320-9666 | 2014-05-17 |
| Find all providers in REIDSVILLE | ||||
| City | REIDSVILLE |
| Zip Code | 30453 |
Please comment or provide details below to improve the information on BENJAMIN ADDRIL 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.