Clarks RX LLC

Organization Active NPI Long Term Care Pharmacy · Centerville, OH

NPI 1154574010 · NPPES record last updated Jul 16, 2026

Key facts

NPI
1154574010
Entity type
Organization (NPI type 2)
Primary specialty
Long Term Care Pharmacy 3336L0003X
License
021907400 (OH)
Legal business name
CLARKS RX LLC
Practice address
922 Senate Dr
Centerville, OH 45459-4017
Phone
(937) 610-3051
Fax
(937) 610-3048
NPI assigned
Oct 23, 2008
Organization subpart
No

Authorized official

Name
Timothy Clark
Title
President
Phone
(937) 610-3051

Other NPIs on the same Medicare enrollment 7

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Corporate family (same tax ID) 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in OH

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20070904000340 OH Part B Supplier - Mass Immunization (Roster Biller Only) 9335232503 11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Centerville, OH; Huber Heights, OH

National Provider Directory

Tax ID family
Clarks RX LLC (3 organizations share this tax ID)

Locations

7060 Solutions Ctr
Chicago, IL 60677

922 Senate Dr
Dayton, OH 45459
Phone (937) 610-3051

710 S Breiel Blvd
Ste A
Middletown, OH 45044

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Long Term Care Pharmacy 3336L0003X 021907400 OH Yes

Addresses

Primary practice location

922 Senate Dr
Centerville, OH 45459-4017

Mailing address

922 Senate Dr
Centerville, OH 45459-4017
Phone (937) 610-3051

Other identifiers

IdentifierTypeStateIssuer
2117533OtherPK

Other names

  • Independent RX Long Term Care Doing business as

Other providers in Centerville, OH

All providers in Centerville, OH · Long Term Care Pharmacy in Ohio

Sources for this page

Verify at the official NPI Registry.