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General NPI Number Information
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NPI Number | 1508840976
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Entity Type | Organization
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Legal Business Name | CMK, LLC
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Dates
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Enumeration Date | 11/30/2005
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 2515 SPRINGS RD NE
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City | HICKORY
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State | NC
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Zip | 28601-3169
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Country | US
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Telephone | 828-256-0084
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Fax | 828-256-0093
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Provider Business Mailing Address
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Address Line | 2515 SPRINGS RD NE
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City | HICKORY
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State | NC
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Zip | 28601-3169
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Country | US
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Telephone | 828-256-0084
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Fax | 828-256-0093
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Authorized Official
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Title or Position | PHARMACIST-IN-CHARGE/OWNER
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Name | MR. DARREN CROW
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Credential | RPH
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Telephone | 828-256-0084
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 09163
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License Number State | NC
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