Organization
CLARKS RX LLC
Active
Other names
The Compounding Lab/Independent RX Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
TIM CLARK (PRESIDENT)
(937) 723-2880
Entity
Organization
Contact information
Practice address
7415 OLD TROY PIKE, HUBER HEIGHTS, OH 45424-2662
(937) 723-2880
(937) 723-2880
Mailing address
7415 OLD TROY PIKE, HUBER HEIGHTS, OH 45424-2662
(937) 723-2880
(937) 428-7978
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
021231250
OH
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2073191
PK
—
05
—
2238859
—
OH
Enumeration date
09/21/2006
Last updated
11/16/2021
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