Healthcare Provider Details

I. General information

NPI: 1730909458
Provider Name (Legal Business Name): THE CLOCK CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/16/2024
Last Update Date: 10/16/2024
Certification Date: 10/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6700 CLAY AVE SW
GRAND RAPIDS MI
49548-7836
US

IV. Provider business mailing address

6700 CLAY AVE SW
GRAND RAPIDS MI
49548-7836
US

V. Phone/Fax

Practice location:
  • Phone: 616-698-9400
  • Fax:
Mailing address:
  • Phone: 616-698-9400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: REBECCA R BUTGEREIT
Title or Position: ACCOUNTING
Credential:
Phone: 616-698-9400