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Organization
CLARK'S SPECIALTY PHARMACY
Active
Organization
CLARK'S SPECIALTY PHARMACY
Active
Other names
Big Country Dermatology Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
CODY CLARK (MANAGER)
(806) 773-5958
Entity
Organization
Contact information
Practice address
17 WINDMILL CIR STE B, ABILENE, TX 79606-5234
(325) 704-5222
Mailing address
1229 RESERVE BLVD STE 100A, SPRING HILL, TN 37174-3273
(806) 451-4799
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
30242
TX
3336C0003X
Community/Retail Pharmacy
—
—
3336C0004X
Compounding Pharmacy
—
—
3336M0002X
Mail Order Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2153704
PK
—
Enumeration date
09/28/2015
Last updated
04/02/2024
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