Organization
CLARKS RX LLC
Active
Other names
CLARKS MR PRESCRIPTION
Organization subpart
No
Provider details
NPI number
Authorized official
TIM CLARK (PRESIDENT)
(937) 428-7970
Entity
Organization
Contact information
Practice address
414 W MAIN ST, TROY, OH 45373-3244
(937) 339-9193
(937) 339-9195
Mailing address
7060 SOLUTION CTR, CHICAGO, IL 60677-0001
(937) 428-7970
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
021502450
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2536349
—
OH
01
—
3673224
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
09/25/2006
Last updated
08/29/2011
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