GEORGE CLARK (NPI# 1780968776) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780968776 |
| Entity Type | Individual |
| Full Name | GEORGE CLARK |
| Credential | RPH |
| Practice Address |
21828 23 Mile Rd Macomb MI 48042-4422 |
| Practice Telephone | 5864211897 |
| Practice Fax Number | 5864211902 |
| Mailing Telephone | 5864211897 |
| Mailing Fax Number | 5864211902 |
| Enumeration Date | 2011-10-07 |
| Last Update Date | 2011-10-07 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 5302019570 | MI | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083099279 | George Clark | Assisted Living Facility | P13 Avon Dr, East Windsor Nj, NJ 08520 | 2015-07-29 |
| 1285900746 | George Wesley Clark | Surgery | 2049 Snapdragon Ln, Alpine, CA 91901-1304 | 2012-03-29 |
| 1699007807 | George James Clark | Pharmacist | 9338 215th Pl, Queens Village, NY 11428-1712 | 2010-02-12 |
| 1851542534 | George Warren Clark | Social Worker | 6750 Lombardy Dr, Chelsea, MI 48118-9586 | 2008-10-01 |
| 1043320773 | George R Clark | Dentist | 610 Old Campbell Rd, Suite 116, Richardson, TX 75080 | 2006-08-30 |
| 1700890415 | George B Clark | Dentist | 430 Kenhorst Blvd, Reading, PA 19611-1830 | 2006-07-28 |
| 1780619403 | George Barnes Clark II | Registered Nurse | 4301 West 7th St, Code 112lr, Little Rock, AR 72205-0000 | 2006-07-11 |
| 1013914126 | George L Clark | Family Medicine | 8740 Rivers Ave, North Charleston, SC 29406-9211 | 2005-07-05 |
| 1750927075 | George Wesley Clark | Technician, Other | 3647 Highway 39, Klamath Falls, OR 97603-2612 | 2019-11-21 |
| 1801452040 | George Clark | Social Worker | 105 Merrick St, Worcester, MA 01609-1937 | 2019-05-14 |
| Street Address |
21828 23 MILE RD |
| City | MACOMB |
| State | MI |
| Zip Code | 48042-4422 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659386795 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 21828 23 Mile Rd, Macomb, MI 48042-4422 | 2006-07-29 |
| 1053696690 | Vijaykumar G Patel | Pharmacist | 21828 23 Mile Rd, Macomb, MI 48042-4422 | 2011-10-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235750431 | Precision Surgery Center LLC | Clinic/Center | 22701 Hall Road, Macomb, MI 48042 | 2020-04-29 |
| 1437573177 | Michael D Pizzimenti | Physical Therapist | 23211 N 21 Mile Road, Macomb, MI 48042 | 2014-02-18 |
| 1518210707 | Kimberly Frances Hodor | Nurse Practitioner | 21840 23 Mile, Macomb, MI 48042 | 2012-10-25 |
| 1952628489 | Frank John Pugliesi | Obstetrics & Gynecology | 49730 S. Thunder Bay Circle, Macomb, MI 48042 | 2010-04-23 |
| 1053575118 | North Macomb Mrt Center LLC | Radiology | 17900 23 Mile Road, Macomb Twp, MI 48042 | 2008-07-17 |
| 1780857870 | Ryan David Vinson | Physical Therapist | 23211 21 Mile Rd, Macomb, MI 48042 | 2008-04-09 |
| 1578690889 | Michael P Nedley | Dentist | 51218 Romeo Plank Rd, Macomb Township, MI 48042 | 2007-02-27 |
| 1477697027 | Amy Hanes | Psychologist | 21592 Doral Dr, Macomb, MI 48042 | 2007-02-16 |
| 1871672055 | Jeffrey Richard Teno | Dentist | 16800 24 Mile, Suite 5, Macomb, MI 48042 | 2006-11-06 |
| 1649389123 | Rite Aid of Michigan Inc | Durable Medical Equipment & Medical Supplies | 15250 24 Mile Road, Macomb, MI 48042 | 2006-08-29 |
| Find all providers in zip 48042 | ||||
| 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 |
|---|---|---|---|---|
| 1649796368 | Mark Petri | Pharmacist | 49188 Frances Dr, Macomb, MI 48044-1638 | 2017-08-15 |
| 1407389570 | Nofal Cholag | Pharmacist | 50340 Nesting Ridge Dr, Macomb, MI 48044 | 2017-04-06 |
| 1578924007 | Diana T Minto | Pharmacist | 52419 Covecreek Dr, Macomb, MI 48042-2949 | 2016-03-10 |
| 1396087383 | Valerie Crabtree | Pharmacist | 1300 E Rebecca Ln, Macomb, IL 61455-3408 | 2013-03-18 |
| 1811234289 | Harry Lucas | Pharmacist | 19668 Cambridge Dr E, Macomb, MI 48044-1277 | 2013-01-05 |
| 1619251097 | Emmanuel Appah | Pharmacist | 48166 Ellington Dr, Macomb, MI 48044-2279 | 2011-10-04 |
| 1154641967 | Anna Aniela Lentocha | Pharmacist | 15250 24 Mile Rd, Macomb, MI 48042-5817 | 2010-06-03 |
| 1871812768 | Robert Orfeo Guerrieri | Pharmacist | 46977 Romeo Plank Rd, Macomb, MI 48044-3509 | 2010-05-18 |
| 1952502775 | Charanjit Kaur Singh | Pharmacist | 49544 Watling St., Macomb, MI 48044 | 2007-05-30 |
| 1841318615 | Thomas William Stites | Pharmacist | 206 Woodchuck Ln, Macomb, IL 61455-9311 | 2007-03-27 |
| Find all providers in MACOMB | ||||
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| 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.