Provider Demographics
NPI:1134470354
Name:CLARK'S MOBILE CARE
Entity Type:Organization
Organization Name:CLARK'S MOBILE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:EUGENE
Authorized Official - Middle Name:ELDRIDGE
Authorized Official - Last Name:CL;ARK
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:916-715-3506
Mailing Address - Street 1:8768 SUGARNOTCH CT
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95758-6751
Mailing Address - Country:US
Mailing Address - Phone:916-399-5661
Mailing Address - Fax:916-399-9182
Practice Address - Street 1:8768 SUGARNOTCH CT
Practice Address - Street 2:
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95758-6751
Practice Address - Country:US
Practice Address - Phone:916-399-5661
Practice Address - Fax:916-399-9182
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-27
Last Update Date:2012-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)