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Contact Information

CLARKS RX LLC
414 W MAIN ST
TROY, OH45373-3244
 Phone: 937-339-9193
 Fax: 937-339-9195
 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 CLARKS RX LLC

NPI Number 1902906001
LBN Legal business name CLARKS RX LLC
Authorized official TIM CLARK - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 09/25/2006
Last updated 08/29/2011 - About 15 years ago
Identifiers
OH License # 021502450
OH Medicaid 2536349
Other 3673224 NCPDP PROVIDER IDENTIFICATION NUMBER
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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