Provider Demographics
NPI:1043426729
Name:SHINABERY'S COMPOUNDING PHARMACY, PLC
Entity Type:Organization
Organization Name:SHINABERY'S COMPOUNDING PHARMACY, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RANDY
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:SHINABERY
Authorized Official - Suffix:JR
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:870-933-6369
Mailing Address - Street 1:1000 E MATTHEWS AVE STE F
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72401-4344
Mailing Address - Country:US
Mailing Address - Phone:870-933-6369
Mailing Address - Fax:870-933-6378
Practice Address - Street 1:1000 E MATTHEWS AVE STE F
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401-4344
Practice Address - Country:US
Practice Address - Phone:870-933-6369
Practice Address - Fax:870-933-6378
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-16
Last Update Date:2009-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAR20228183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty