Provider Demographics
NPI:1497996144
Name:CLARK ENTERPRISES 2000, INC.
Entity Type:Organization
Organization Name:CLARK ENTERPRISES 2000, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:CLARK-OTTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-825-7172
Mailing Address - Street 1:240 E BERG RD
Mailing Address - Street 2:
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401-8907
Mailing Address - Country:US
Mailing Address - Phone:785-825-7172
Mailing Address - Fax:785-825-7173
Practice Address - Street 1:240 E BERG RD
Practice Address - Street 2:
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401-8907
Practice Address - Country:US
Practice Address - Phone:785-825-7172
Practice Address - Fax:785-825-7173
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-10
Last Update Date:2015-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies