Provider Demographics
NPI:1184922049
Name:MCCLARY, VERNET
Entity type:Individual
Prefix:
First Name:VERNET
Middle Name:
Last Name:MCCLARY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:469 ROBINS EGG DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29229-6814
Mailing Address - Country:US
Mailing Address - Phone:803-546-3947
Mailing Address - Fax:803-708-8009
Practice Address - Street 1:469 ROBINS EGG DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29229-6814
Practice Address - Country:US
Practice Address - Phone:803-546-3947
Practice Address - Fax:803-708-8009
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-02
Last Update Date:2011-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2011-41461-40612374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide