Provider Demographics
NPI:1003203878
Name:R & R MEDICAL INC
Entity Type:Organization
Organization Name:R & R MEDICAL INC
Other - Org Name:MEDICAL ARTS PHARMACY ELKINS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PHIL
Authorized Official - Middle Name:
Authorized Official - Last Name:ROZELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:479-443-3411
Mailing Address - Street 1:2515 E HUNTSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72701-7329
Mailing Address - Country:US
Mailing Address - Phone:479-443-3411
Mailing Address - Fax:479-443-3412
Practice Address - Street 1:2127 N CENTER ST
Practice Address - Street 2:SUITE 1
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72701-9449
Practice Address - Country:US
Practice Address - Phone:479-296-6041
Practice Address - Fax:479-296-6069
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-20
Last Update Date:2021-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAR208013336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2162588OtherPK
AR216993407Medicaid