STACY CLARK (NPI# 1689950479) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1689950479 |
Entity Type | Individual |
Full Name | STACY CLARK |
Credential | RPH |
Practice Address |
52482 State Road 933 South Bend IN 46637-3852 |
Practice Telephone | 5742710357 |
Mailing Telephone | 5742710357 |
Enumeration Date | 2011-10-25 |
Last Update Date | 2011-10-25 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 183500000X | Pharmacist | 26016810 | IN | Pharmacy Service Providers |
Y | 183500000X | Pharmacist | 5302026870 | MI | Pharmacy Service Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1861628380 | Stacy Clark | Counselor | 2156 Seastone Trce, Chesapeake, VA 23321-3777 | 2009-06-10 |
1912016494 | Stacy Ann Clark | Optometrist | 1601 E Iron Ave, Salina, KS 67401-3237 | 2006-08-29 |
1801841606 | Stacy Suzanne Clark | Chiropractor | 6 Ebco Circle, Waynesboro, VA 22980 | 2006-05-23 |
1669012647 | Stacy Ann Clark | Counselor | 460 Briarwood Dr Ste 510, Jackson, MS 39206-3057 | 2020-01-08 |
1881047124 | Stacy Clark | Marriage & Family Therapist | 24451 Health Center Dr, Laguna Hills, CA 92653-3689 | 2016-07-21 |
1295199941 | Stacy Ann Clark | Nurse Practitioner | 3245 Mount Moriah Ave, Suite 10, Owensboro, KY 42303-7834 | 2016-04-08 |
1053625764 | Stacy Clark | Psychologist | 25 E Washington St, 1719, Chicago, IL 60602-1708 | 2010-08-05 |
1114259637 | Stacy L Clark | Massage Therapist | 6290 W Sample Rd, Coral Springs, FL 33067-3101 | 2010-02-09 |
1134375314 | Stacy Clark | Physical Therapist | 11623 Arbor St, Omaha, NE 68144-2981 | 2008-08-07 |
1619145497 | Stacy Clark | Counselor | 367 Pine St, Springfield, MA 01105-1930 | 2008-02-14 |
Street Address |
52482 STATE ROAD 933 |
City | SOUTH BEND |
State | IN |
Zip Code | 46637-3852 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1215232228 | Larry Taylor | Pharmacist | 52482 State Road 933, South Bend, IN 46637-3852 | 2011-01-21 |
1447659784 | Alexander Figueroa | Pharmacist | 52482 State Road 933, South Bend, IN 46637-3852 | 2014-08-21 |
1689957516 | Seyoum Tekie Woldegebriel | Pharmacist | 52482 State Road 933, South Bend, IN 46637-3852 | 2011-09-27 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1851715155 | Rachel Cundiff | Pharmacist | 52482 Sr 933 N, South Bend, IN 46637 | 2014-02-07 |
1821427857 | Hancock Regional Hospital | Skilled Nursing Facility | 52565 Sr 933, South Bend, IN 46637 | 2013-11-12 |
1437587854 | Triple L Associates | Durable Medical Equipment & Medical Supplies | 227 Dixie Way North, Suite 110, South Bend, IN 46637 | 2013-10-22 |
1104251479 | Tao Bai | Pharmacist | 52482 State Rd 933, South Bend, IN 46637 | 2013-09-05 |
1801152210 | Richard James Holloway | Urology | 18799 Arapaho Ln, South Bend, IN 46637 | 2012-04-10 |
1255613618 | Angela Taylor | Pharmacist | 52482 St Rd 933 N, South Bend, IN 46637 | 2011-09-12 |
1831345248 | Cherlyn Po | Occupational Therapist | 52654 N Ironwood Rd, South Bend, IN 46637 | 2008-08-18 |
1164599304 | Decatur County Memorial Hospital | Alzheimer Center (Dementia Center) | 18325 Bailey Ave, South Bend, IN 46637 | 2006-11-30 |
1831572478 | Patrick Kelly | Occupational Therapy Assistant | 52565 Sr 933, South Bend, IN 46637 | 2015-07-01 |
1083262992 | Francesca E Udoh | Nurse Practitioner | 51875 Whitestable Ln, South Bend, IN 46637-1371 | 2019-09-04 |
Find all providers in zip 46637 |
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 |
---|---|---|---|---|
1255945705 | Richard B Pearson | Pharmacist | 2913 S Michigan St, South Bend, IN 46614-1033 | 2020-09-02 |
1033759394 | Diane Galvas | Pharmacist | 1217 E. Ireland Rd., South Bend, IN 46614 | 2020-01-14 |
1053899617 | Korilyn Hauersperger | Pharmacist | 22370 Ice Trl, South Bend, IN 46614-4401 | 2018-08-05 |
1386159622 | Dusti Ann Yost | Pharmacist | 707 N Michigan St Ste 114, South Bend, IN 46601-1068 | 2017-12-08 |
1851715155 | Rachel Cundiff | Pharmacist | 52482 Sr 933 N, South Bend, IN 46637 | 2014-02-07 |
1104251479 | Tao Bai | Pharmacist | 52482 State Rd 933, South Bend, IN 46637 | 2013-09-05 |
1285989079 | Craig Merrick | Pharmacist | 901 E Donald St, South Bend, IN 46613-2920 | 2012-07-17 |
1396021218 | Jada Rashon Bush | Pharmacist | 201 S William St Ste 202, South Bend, IN 46601-2515 | 2011-10-24 |
1609151596 | Monica Lynn Parkhurst | Pharmacist | 54590 Ironwood Rd, South Bend, IN 46635-1617 | 2011-10-11 |
1437433406 | Angela Nicole Zolvinski | Pharmacist | 4444 W. Western Ave, South Bend, IN 46619 | 2011-10-07 |
Find all providers in SOUTH BEND |
City | SOUTH BEND |
Zip Code | 46637 |
Please comment or provide details below to improve the information on STACY 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.