STACY CLARK


Address: 52482 State Road 933, South Bend, IN 46637-3852
Phone: 5742710357

STACY CLARK (NPI# 1689950479) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

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

Taxonomy

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

Other Providers STACY CLARK

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

Office Location

Street Address 52482 STATE ROAD 933
City SOUTH BEND
State IN
Zip Code 46637-3852

Providers in the same location

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

Providers in the same zip code

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 Information

Taxonomy Code 183500000X
Grouping Pharmacy Service Providers
Classification Pharmacist

Taxonomy Definition

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]

Providers in the same taxonomy and city

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

Competitor

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City SOUTH BEND
Zip Code 46637

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Dataset Information

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.

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