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Contact Information

CLARK RX LLC
710 S BREIEL BLVD STE B
MIDDLETOWN, OH45044-6202
 Phone: 513-261-6053
 Fax: 513-261-6054
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
 

Pharmacy

333600000X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for CLARK RX LLC

NPI # 1699047423
LBN Legal business name CLARK RX LLC
Authorized official TIMOTHY CLARK - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 02/09/2012
Last updated 04/25/2016 - About 10 years ago
Identifiers
OH License # 022201700
Other 2133770 PK
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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