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Organization

CLARK RX LLC

Active
Other names
CLARK'S RX PHARMACY
Organization subpart
No

Provider details

NPI number
Authorized official
TIMOTHY CLARK (PRESIDENT)
(937) 428-7970
Entity
Organization

Contact information

Practice address
710 S BREIEL BLVD STE B, MIDDLETOWN, OH 45044-6202
(513) 261-6053
(513) 261-6054
Mailing address
7333 PARAGON RD, SUITE 160, CENTERVILLE, OH 45459-4155
(937) 428-7970
(937) 428-7978

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
3336C0003X
Community/Retail Pharmacy
Primary
022201700
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2133770
PK
Enumeration date
02/09/2012
Last updated
04/25/2016
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