Cip Northside LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

CIP NORTHSIDE LLC

Practice address

3802 Catclaw Dr Ste 2
Abilene, TX 79606-8253

Phone

(806) 451-4799

Fax

(325) 305-0565

NPI assigned

Dec 18, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Cody Clark, PHARM.D.NPI 1972271260

Title

Managing Officer

Phone

(806) 451-4799

Specialties & licenses 1

Addresses

Other names 1

• CIP Northside Pharmacy Doing business as

Locations

Practitioners 1

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

• Cody Clark, PHARMD

  • Pharmacist
  • Spring Hill, TN
  • NPI 1972271260
  NPD Authorized official

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

{
    "created_epoch": "1608249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1608249600000",
    "number": "1891381265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1113 MURFREESBORO RD STE 106-410",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370641306",
            "telephone_number": "806-451-4799",
            "fax_number": "325-305-0565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3802 CATCLAW DR STE 2",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796068253",
            "telephone_number": "806-451-4799",
            "fax_number": "325-305-0565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CIP NORTHSIDE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-18",
        "last_updated": "2020-12-18",
        "certification_date": "2020-12-18",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "CODY",
        "authorized_official_title_or_position": "MANAGING OFFICER",
        "authorized_official_telephone_number": "806-451-4799",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARM.D."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CIP Northside Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Cassie Christian, LCSW
• Caitlin Elizabeth Christiansen, PA-C
• Christopher S. Eddleman, M.D., PHD, PLLC
• Bogdan A Chumak, MD
• Cip Northside LLC
• City of Abilene
• CL Haven Enterprises
• Aaron Jonathan Clark, PA
• Charles Leroy Clark III, M.D.
• Jim Clark, RPH

• Community/Retail Pharmacy in Abilene, TX
• Providers in Abilene, TX by specialty
• Community/Retail Pharmacy in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.