NPIMap

Organization Active NPI

Clark'S RX LLC

  • Community/Retail Pharmacy
  • Lima, OH
National Provider Identifier
1992885461
Registry record updated Sep 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
RTP02014460003 Issued in OH
Legal business name
CLARK'S RX LLC
Practice address
701 W Market St
Lima, OH 45801-4601
Phone
(419) 223-8906
Fax
(419) 222-1619
NPI assigned
Oct 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2014

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

Authorized official

Name
Tim Richard Clark, RPH
Title
Owner/President
Phone
(419) 223-8906

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X RTP02014460003 OH Primary
Compounding Pharmacy 3336C0004X

Addresses

Primary practice location

701 W Market St
Lima, OH 45801-4601

Mailing address

701 W Market St
Lima, OH 45801-4601
Phone (419) 223-8906

Other identifiers 2

IdentifierTypeStateIssuer
0337451MedicaidOH
2072874OtherPK

Other names 1

  • Clark's RX Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Clarks RX LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

701 W Market St
Lima, OH 45801
Phone (419) 223-8906

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411603200000",
    "number": "1992885461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 W MARKET ST",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458014601",
            "telephone_number": "419-223-8906",
            "fax_number": "419-222-1619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 W MARKET ST",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458014601",
            "telephone_number": "419-223-8906",
            "fax_number": "419-222-1619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARK'S RX LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-17",
        "last_updated": "2014-09-25",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "TIM",
        "authorized_official_middle_name": "RICHARD",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "419-223-8906",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OH",
            "license": "RTP02014460003",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0337451",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2072874",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clark's RX",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lima, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2014; 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.