Clark'S Pharmacy, Inc

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

Legal business name

CLARK'S PHARMACY, INC

Practice address

1946 42ND St NE
Cedar Rapids, IA 52402-3041

Phone

(319) 393-3210

Fax

(319) 393-2747

NPI assigned

Apr 12, 2019

Organization subpart

No

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

Authorized official

Name

Mr. Craig Leo Clark, RPHNPI 1487609111

Title

RPH/Owner

Phone

(319) 393-3210

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Tax ID family

Clark'S Pharmacy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Clark'S Pharmacy, Inc

  • Community/Retail Pharmacy
  • Cedar Rapids, IA
  • NPI 1285732503
  NPD tax ID

Practitioners 1

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

• Craig Leo Clark, RPH

  • Pharmacist
  • Cedar Rapids, IA
  • NPI 1487609111
  NPD Authorized official

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

{
    "created_epoch": "1555027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1555027200000",
    "number": "1952864233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1946 42ND ST NE",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524023041",
            "telephone_number": "319-393-3210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1946 42ND ST NE",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524023041",
            "telephone_number": "319-393-3210",
            "fax_number": "319-393-2747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARK'S PHARMACY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-12",
        "last_updated": "2019-04-12",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_middle_name": "LEO",
        "authorized_official_title_or_position": "RPH/OWNER",
        "authorized_official_telephone_number": "319-393-3210",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0133439",
            "state": "IA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "clarksrx@imonmail.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1946 42nd St NE",
            "city": "Cedar Rapids",
            "state": "IA",
            "country_code": "US",
            "postal_code": "524023041",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Katie Lynn Clark, ARNP
• Ryan Christopher Clark, PHARMD
• Samantha Clark, LCSW
• Sara Lee Clark, CCC-A
• Clark'S Pharmacy, Inc
• Clarks Medical Services LLC
• Brittany Clary, BA
• Bailey J Clasen, LISW
• Class a Mso LLC
• Clear Path Counseling

• Long Term Care Pharmacy in Cedar Rapids, IA
• Providers in Cedar Rapids, IA by specialty
• Long Term Care Pharmacy in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2019; 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.