# CLARK'S TENNESSEE PHARMACY LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Big Country Dermatology Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1598339566
- **Authorized official:** CODY CLARK PHARMD (CEO)
- **Authorized official phone:** (806) 773-5958

## Contact information

- **Practice address:** 1229 RESERVE BLVD STE 100, SPRING HILL, TN 37174-3273
- **Practice address phone:** (931) 487-1700
- **Practice address fax:** (931) 487-1720
- **Mailing address:** 1229 RESERVE BLVD STE 100A, SPRING HILL, TN 37174-3273
- **Mailing address phone:** (806) 451-4799

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | — | Yes |

## Other

- **Enumeration date:** 05/14/2021
- **Last updated:** 04/02/2024