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Organization
MR PRESCRIPTION INC
Active
Organization
MR PRESCRIPTION INC
Active
Other names
CLARK'S RX PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
TIM CLARK (PRESIDENT)
(937) 428-7970
Entity
Organization
Contact information
Practice address
6149 FAR HILLS AVE, CENTERVILLE, OH 45459-1925
(937) 433-6669
(937) 433-6659
Mailing address
7044 SOLUTION CTR, CHICAGO, IL 60677-0001
(937) 428-7970
(937) 428-7978
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
02731100
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0908647
—
OH
01
—
3657939
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
09/21/2006
Last updated
08/29/2011
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