Organization
CLARK'S PHARMACY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CRAIG LEO CLARK RPH (RPH/OWNER)
(319) 393-3210
Entity
Organization
Contact information
Practice address
1946 42ND ST NE, CEDAR RAPIDS, IA 52402-3041
(319) 393-3210
(319) 393-2747
Mailing address
1946 42ND ST NE, CEDAR RAPIDS, IA 52402-3041
(319) 393-3210
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0133439
—
IA
Enumeration date
04/12/2019
Last updated
04/12/2019
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