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Organization

CLARKS RX LLC

Active
Other names
Independent RX Long Term Care
Organization subpart
No

Provider details

NPI number
Authorized official
TIMOTHY CLARK (PRESIDENT)
(937) 610-3051
Entity
Organization

Contact information

Practice address
922 SENATE DR, CENTERVILLE, OH 45459-4017
(937) 610-3051
(937) 610-3048
Mailing address
922 SENATE DR, CENTERVILLE, OH 45459-4017
(937) 610-3051

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
3336L0003X
Long Term Care Pharmacy
Primary
021907400
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2117533
PK
Enumeration date
10/23/2008
Last updated
11/03/2021
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