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General NPI Number Information
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NPI Number | 1740810290
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Entity Type | Organization
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Legal Business Name | A AND D CLARK COMPANY
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Dates
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Enumeration Date | 01/23/2020
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Last Update Date | 01/23/2020
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Provider Practice Location Address
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Address Line | 4812 FREDERICK PIKE
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City | DAYTON
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State | OH
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Zip | 45414-3835
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Country | US
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Telephone | 937-949-7095
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Fax | 937-723-6419
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Provider Business Mailing Address
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Address Line | 4812 FREDERICK PIKE
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City | DAYTON
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State | OH
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Zip | 45414-3835
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Country | US
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Telephone | 937-949-7095
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Fax | 937-723-6419
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Authorized Official
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Title or Position | EXCUTIVE DIRECTOR
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Name | ARTHUR C CLARK III
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Credential |
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Telephone | 937-949-7095
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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