Clark, Charles John

Clark, Charles John is an individual health care provider with primary practice located at 203 So. Daisy , Salmon ID 83467. He recently has only one registered license in Pharmacy Service Providers / Pharmacist, which is considered as his primary health care specialty. Clark, Charles John can be contacted via phone (208) 756-5672.

Contact Information

Primary practice address
203 So. Daisy Salmon ID 83467
Phone: (208) 756-5672
Fax: (208) 756-5757
Website:
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Health care specialties

SpecialtyCodeLicense #State
Pharmacy Service Providers / Pharmacist 183500000X P-4334 Idaho

Profile Details

NPI number 1689826984
LBN Legal business name Clark, Charles John
Credentials R.PH.
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 17th, 2008
Last updated Oct 17th, 2008 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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