Organization
CLARK DRUG COMPANY, LLC
Active
Other names
Caledonia Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT JUSTIN CLARK PHARMD (OWNER/ PHARMACIST IN CHARGE)
(662) 356-4000
Entity
Organization
Contact information
Practice address
741 MAIN ST, CALEDONIA, MS 39740-7609
(662) 356-4000
(662) 356-4044
Mailing address
PO BOX 478, CALEDONIA, MS 39740-0478
(662) 356-4000
(662) 356-4044
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
09552/1.1
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03406798
—
MS
Enumeration date
11/14/2011
Last updated
05/19/2023
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