Provider Demographics
NPI:1295917243
Name:CLARK, FRANCIS NATHANIEL III (RPH)
Entity type:Individual
Prefix:MR
First Name:FRANCIS
Middle Name:NATHANIEL
Last Name:CLARK
Suffix:III
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 1:98 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08827-2766
Mailing Address - Country:US
Mailing Address - Phone:908-303-8137
Mailing Address - Fax:908-574-5293
Practice Address - Street 1:98 MAIN ST
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:NJ
Practice Address - Zip Code:08827
Practice Address - Country:US
Practice Address - Phone:908-303-8137
Practice Address - Fax:908-574-5293
Is Sole Proprietor?:No
Enumeration Date:2007-12-02
Last Update Date:2018-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP449806183500000X
NJ28RI01469400183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist