# CLARKS RX LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Clark's Rx Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1710257902
- **Authorized official:** TIMOTHY CLARK (PRESIDENT)
- **Authorized official phone:** (937) 428-7970

## Contact information

- **Practice address:** 9749 MONTGOMERY RD, CINCINNATI, OH 45242-7207
- **Practice address phone:** (513) 618-0185
- **Practice address fax:** (513) 618-0186
- **Mailing address:** 7060 SOLUTIONS CENTER DR, CHICAGO, IL 60677-0001
- **Mailing address phone:** (937) 428-7970
- **Mailing address fax:** (937) 428-7978

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 022177150 | OH | Yes |

## Other

- **Enumeration date:** 01/05/2012
- **Last updated:** 12/13/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 3680142 | NCPDP PROVIDER IDENTIFICATION NUMBER | — |