# CLARKS RX LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** The Compounding Lab/Independent RX Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1184723652
- **Authorized official:** TIM CLARK (PRESIDENT)
- **Authorized official phone:** (937) 723-2880

## Contact information

- **Practice address:** 7415 OLD TROY PIKE, HUBER HEIGHTS, OH 45424-2662
- **Practice address phone:** (937) 723-2880
- **Practice address fax:** (937) 723-2880
- **Mailing address:** 7415 OLD TROY PIKE, HUBER HEIGHTS, OH 45424-2662
- **Mailing address phone:** (937) 723-2880
- **Mailing address fax:** (937) 428-7978

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 021231250 | OH | Yes |
| 3336C0004X | Compounding Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 09/21/2006
- **Last updated:** 11/16/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2073191 | PK | — |
| 05 | — | 2238859 | — | OH |