Organization
CLARKS PHARMACY INC
Active
Other names
CLARKS PHARMACY INC
Organization subpart
No
Provider details
NPI number
Authorized official
JERRY CLARK (PRES)
(434) 392-8665
Entity
Organization
Contact information
Practice address
119 A N MAIN STREET, FARMVILLE, VA 23901
(434) 392-1411
(434) 392-1991
Mailing address
PO BOX 247, FARMVILLE, VA 23901-0247
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
0201002540
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008502722
—
VA
01
—
2104739
PK
—
Enumeration date
10/02/2006
Last updated
05/01/2013
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