Organization
CLARKS 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
9749 MONTGOMERY RD, CINCINNATI, OH 45242-7207
(513) 618-0185
(513) 618-0186
Mailing address
7060 SOLUTIONS CENTER DR, CHICAGO, IL 60677-0001
(937) 428-7970
(937) 428-7978
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
022177150
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3680142
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
01/05/2012
Last updated
12/13/2012
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