Provider Demographics
NPI:1396958229
Name:CLARKE, JAMES N (RPH)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:N
Last Name:CLARKE
Suffix:
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 1:23 HARBOR HILL ROAD
Mailing Address - Street 2:
Mailing Address - City:GROSSE PTE FARMS
Mailing Address - State:MI
Mailing Address - Zip Code:48236
Mailing Address - Country:US
Mailing Address - Phone:313-885-5876
Mailing Address - Fax:
Practice Address - Street 1:100 W. BIG BEAVER ROAD
Practice Address - Street 2:SUITE 600
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48084-5209
Practice Address - Country:US
Practice Address - Phone:248-925-1774
Practice Address - Fax:888-373-3059
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302020855183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist