Clark, Mark Wayne
Clark, Mark Wayne is an sole proprietor health care provider with primary practice located at 134 Block St , Marion AR 72364-1956. He recently has only one registered license in Suppliers / Community/Retail Pharmacy, which is considered as his primary health care specialty. Clark, Mark Wayne can be contacted via phone (870) 739-1111.Contact Information
Primary practice address
134 Block St
Marion AR 72364-1956
Phone: (870) 739-1111
Fax: (870) 739-1116
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Community/Retail Pharmacy | 3336C0003X | AR20895 | Arkansas |
Profile Details
| NPI number | 1659856185 |
|---|---|
| LBN Legal business name | Clark, Mark Wayne |
| Credentials | DBA MARION FAMILY |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 1st, 2018 |
| Last updated | Feb 23rd, 2019 - about 7 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1659856185 | NPPES |
| Other | 0426355 | NCPDP |
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