Provider Demographics
NPI:1912156282
Name:CLCD ENTERPRISE INC
Entity Type:Organization
Organization Name:CLCD ENTERPRISE INC
Other - Org Name:TRUCK'N AMERICA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:MORRISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-932-4510
Mailing Address - Street 1:2130 OLD WASHINGTON RD
Mailing Address - Street 2:
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20601-3179
Mailing Address - Country:US
Mailing Address - Phone:301-932-4510
Mailing Address - Fax:301-932-4521
Practice Address - Street 1:2130 OLD WASHINGTON RD
Practice Address - Street 2:
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20601-3179
Practice Address - Country:US
Practice Address - Phone:301-932-4510
Practice Address - Fax:301-932-4521
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-11
Last Update Date:2008-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD09109515332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies