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Organization

CLARK PHARMACY LLC

Active
Parent organization
LIFECHEK, INC
Other names
LIFECHEK DRUG #7
Organization subpart
Yes

Provider details

NPI number
Legal business name
LIFECHEK, INC
Authorized official
BRUCE GINGRICH (OWNER/PRESIDENT)
(281) 232-3940
Entity
Organization

Contact information

Practice address
502 W MONTGOMERY ST, WILLIS, TX 77378-8827
(936) 856-4594
(936) 856-3512
Mailing address
1316 7TH ST, ROSENBERG, TX 77471-3531
(281) 232-3940
(832) 595-1203

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
3336C0003X
Community/Retail Pharmacy
Primary
24189
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
140591
TX
01
4510687
NCPDP PROVIDER IDENTIFICATION NUMBER
Enumeration date
08/20/2006
Last updated
03/30/2011
About Stedi
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Product
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  • Eligibility checks
  • EDI platform