# CLARK'S RX LLC

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

## Provider details

- **NPI number:** 1992885461
- **Authorized official:** TIM RICHARD CLARK RPH (OWNER/PRESIDENT)
- **Authorized official phone:** (419) 223-8906

## Contact information

- **Practice address:** 701 W MARKET ST, LIMA, OH 45801-4601
- **Practice address phone:** (419) 223-8906
- **Practice address fax:** (419) 222-1619
- **Mailing address:** 701 W MARKET ST, LIMA, OH 45801-4601
- **Mailing address phone:** (419) 223-8906
- **Mailing address fax:** (419) 222-1619

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | RTP02014460003 | OH | Yes |
| 3336C0004X | Compounding Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 10/17/2006
- **Last updated:** 09/25/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0337451 | — | OH |
| 01 | — | 2072874 | PK | — |