Provider Demographics
NPI:1326525098
Name:NASH, SLATER CLARK JR (RPH)
Entity Type:Individual
Prefix:MR
First Name:SLATER
Middle Name:CLARK
Last Name:NASH
Suffix:JR
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7900 E ARROWHEAD PKWY APT 344
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57110-7021
Mailing Address - Country:US
Mailing Address - Phone:614-581-7935
Mailing Address - Fax:
Practice Address - Street 1:2165 BRYTON DR
Practice Address - Street 2:
Practice Address - City:POWELL
Practice Address - State:OH
Practice Address - Zip Code:43065-9198
Practice Address - Country:US
Practice Address - Phone:614-581-7935
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-25
Last Update Date:2019-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH032165031835N1003X, 183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835N1003XPharmacy Service ProvidersPharmacistNutrition Support