Provider Demographics
NPI:1821653650
Name:CLARK CONTRACTING CO. INC.
Entity Type:Organization
Organization Name:CLARK CONTRACTING CO. INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:H
Authorized Official - Last Name:CLARK
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:302-765-2228
Mailing Address - Street 1:PO BOX 7756
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19803-0756
Mailing Address - Country:US
Mailing Address - Phone:302-765-2228
Mailing Address - Fax:
Practice Address - Street 1:1511 GRAYROCK DR
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19803-3906
Practice Address - Country:US
Practice Address - Phone:302-765-2228
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-07
Last Update Date:2019-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171WH0202XOther Service ProvidersContractorHome ModificationsGroup - Single Specialty