Organization Active NPI

Monical Drug Inc

Doing business as Clark Pharmacy

  • Community/Retail Pharmacy
  • Cimarron, KS
National Provider Identifier
1609203058
Registry record updated Jan 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
213010 Issued in KS
Legal business name
MONICAL DRUG INC
Doing business as
Clark Pharmacy
Practice address
104 S Main St
Cimarron, KS 67835-8875
Phone
(620) 855-2242
Fax
(620) 855-3616
NPI assigned
Oct 1, 2013
Last updated
Jan 16, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2026

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

Authorized official

Name
Matthew Dylan Monical, PHARMDNPI 1417246513
Title
Owner
Phone
(620) 855-2242

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU
Pharmacy 333600000X NU
Community/Retail Pharmacy 3336C0003X 213010 KS Primary
Long Term Care Pharmacy 3336L0003X NU
Compounding Pharmacy 3336C0004X NU

Addresses

Primary practice location

104 S Main St
Cimarron, KS 67835-8875

Mailing address

PO Box 207
Cimarron, KS 67835-0207
Phone (620) 855-2242

Other identifiers 2

IdentifierTypeStateIssuer
201089810AMedicaidKS
2143009OtherPK

Other names 1

  • Clark Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20140130000687 KS DME Supplier - Pharmacy 1355570938 Practice locations: Cimarron, KS
O20160113000241 KS Part B Supplier - Mass Immunization (Roster Biller Only) 1355570938 Practice locations: Cimarron, KS

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
17D2176434Clark Pharmacy104 S Main, Cimarron, KS 67835Certificate of waiverDec 12, 2027

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Clark Pharmacy104 S Main St, Cimarron, KS 67835-8875(620) 855-2242 Immunosuppressive Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Commodes, Urinals, Bedpans|Blood Glucose Monitors/Supplies (Non-Mail Order)|Canes and/or Crutches|Walkers|Ostomy Supplies|Nebulizer Equipment and/or Supplies Does not accept assignmentParticipating since Jan 1, 2014

National Provider Directory

National Provider Directory

Locations

104 S Main St
Cimarron, KS 67835
Phone (620) 855-2242

Practitioners & affiliated clinicians

Practitioners 2

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": "1380585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768521600000",
    "number": "1609203058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 207",
            "city": "CIMARRON",
            "state": "KS",
            "postal_code": "678350207",
            "telephone_number": "620-855-2242",
            "fax_number": "620-855-3616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 S MAIN ST",
            "city": "CIMARRON",
            "state": "KS",
            "postal_code": "678358875",
            "telephone_number": "620-855-2242",
            "fax_number": "620-855-3616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONICAL DRUG INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-01",
        "last_updated": "2026-01-16",
        "certification_date": "2026-01-16",
        "status": "A",
        "authorized_official_last_name": "MONICAL",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "DYLAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "620-855-2242",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "KS",
            "license": "213010",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201089810A",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2143009",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clark Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cimarron, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.