Provider Demographics
NPI:1508840976
Name:CMK, LLC
Entity Type:Organization
Organization Name:CMK, LLC
Other - Org Name:MARKET DRUG
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST-IN-CHARGE/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DARREN
Authorized Official - Middle Name:
Authorized Official - Last Name:CROW
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:828-256-0084
Mailing Address - Street 1:2515 SPRINGS RD NE
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28601-3169
Mailing Address - Country:US
Mailing Address - Phone:828-256-0084
Mailing Address - Fax:828-256-0093
Practice Address - Street 1:2515 SPRINGS RD NE
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28601-3169
Practice Address - Country:US
Practice Address - Phone:828-256-0084
Practice Address - Fax:828-256-0093
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-30
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC09163333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0186264Medicaid
NC3404706OtherNABP OR NCPDP
NC3404706OtherNABP OR NCPDP