Clark Medical, Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

5359160001 Issued in NC

Legal business name

CLARK MEDICAL, INC

Practice address

430 Brady Hampton Dr
Rutherfordton, NC 28139-7017

Phone

(828) 288-9447

Fax

(828) 288-9373

NPI assigned

Oct 11, 2006

Last updated

Apr 2, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Phillip Douglas Clark Sr.

Title

President

Phone

(828) 288-9447

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207094400000",
    "number": "1962591867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 BRADY HAMPTON DR",
            "city": "RUTHERFORDTON",
            "state": "NC",
            "postal_code": "281397017",
            "telephone_number": "828-288-9447",
            "fax_number": "828-288-9373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 BRADY HAMPTON DR",
            "city": "RUTHERFORDTON",
            "state": "NC",
            "postal_code": "281397017",
            "telephone_number": "828-288-9447",
            "fax_number": "828-288-9373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARK MEDICAL, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-11",
        "last_updated": "2008-04-02",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_middle_name": "DOUGLAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "828-288-9447",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NC",
            "license": "5359160001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Providers in Rutherfordton, NC by specialty
• Durable Medical Equipment & Medical Supplies in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.