Provider Demographics
NPI:1225642721
Name:CUMMINGS, CLAY ISAAC (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:CLAY
Middle Name:ISAAC
Last Name:CUMMINGS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 N 600 E
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:IN
Mailing Address - Zip Code:47558-5532
Mailing Address - Country:US
Mailing Address - Phone:812-787-0578
Mailing Address - Fax:
Practice Address - Street 1:2000 STATE ST
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:IN
Practice Address - Zip Code:47501-8505
Practice Address - Country:US
Practice Address - Phone:812-257-2505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-02
Last Update Date:2020-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26028693A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist