Clark Medical, Inc
Organization Active NPI Durable Medical Equipment & Medical Supplies · Rutherfordton, NC
NPI 1962591867 · NPPES record last updated Apr 2, 2008
Key facts
- NPI
- 1962591867
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Durable Medical Equipment & Medical Supplies 332B00000X
- License
- 5359160001 (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
- Organization subpart
- No
Authorized official
- Name
- Mr. Phillip Douglas Clark Sr.
- Title
- President
- Phone
- (828) 288-9447
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | 5359160001 | NC | Yes |
Addresses
Primary practice location
430 Brady Hampton Dr
Rutherfordton, NC 28139-7017
Mailing address
430 Brady Hampton Dr
Rutherfordton, NC 28139-7017
Phone (828) 288-9447
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7703506 | Medicaid | NC |
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- Joy Chapman
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- Cleveland Health Ventures LLC
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- Michael Barry Couser
- Kerry Natasha Crain
- Brenton S Curry
All providers in Rutherfordton, NC · Durable Medical Equipment & Medical Supplies in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 2, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.