NPIMap

Organization Active NPI

Clarks RX LLC

Doing business as The Compounding Lab/Independent RX Pharmacy

  • Community/Retail Pharmacy
  • Huber Heights, OH
National Provider Identifier
1184723652
Registry record updated Nov 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
021231250 Issued in OH
Legal business name
CLARKS RX LLC
Doing business as
The Compounding Lab/Independent RX Pharmacy
Practice address
7415 Old Troy Pike
Huber Heights, OH 45424-2662
Phone
(937) 723-2880
Fax
(937) 723-2880
NPI assigned
Sep 21, 2006
Last updated
Nov 16, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Tim Clark
Title
President
Phone
(937) 723-2880

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 021231250 OH Primary
Compounding Pharmacy 3336C0004X

Addresses

Primary practice location

7415 Old Troy Pike
Huber Heights, OH 45424-2662

Mailing address

7415 Old Troy Pike
Huber Heights, OH 45424-2662
Phone (937) 723-2880

Other names 1

  • The Compounding Lab/Independent RX Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

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

Other NPIs on the same Medicare enrollment 7

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

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

7415 Troy Pike
Huber Heights, OH 45424
Phone (937) 723-2880

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637020800000",
    "number": "1184723652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7415 OLD TROY PIKE",
            "city": "HUBER HEIGHTS",
            "state": "OH",
            "postal_code": "454242662",
            "telephone_number": "937-723-2880",
            "fax_number": "937-428-7978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7415 OLD TROY PIKE",
            "city": "HUBER HEIGHTS",
            "state": "OH",
            "postal_code": "454242662",
            "telephone_number": "937-723-2880",
            "fax_number": "937-723-2880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARKS RX LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-21",
        "last_updated": "2021-11-16",
        "certification_date": "2021-10-29",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "TIM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "937-723-2880"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OH",
            "license": "021231250",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Compounding Lab/Independent RX Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Huber Heights, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.