Provider Demographics
NPI:1053311969
Name:POWER FAMILY ENTERPRISES INC
Entity Type:Organization
Organization Name:POWER FAMILY ENTERPRISES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:JACQUE
Authorized Official - Middle Name:
Authorized Official - Last Name:HOWARD
Authorized Official - Suffix:
Authorized Official - Credentials:PD
Authorized Official - Phone:870-845-1413
Mailing Address - Street 1:PO BOX 147
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:71852-0147
Mailing Address - Country:US
Mailing Address - Phone:870-845-1413
Mailing Address - Fax:870-845-2304
Practice Address - Street 1:1310 S 4TH ST
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:AR
Practice Address - Zip Code:71852-3007
Practice Address - Country:US
Practice Address - Phone:870-845-1413
Practice Address - Fax:870-845-2304
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-21
Last Update Date:2019-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR05046333600000X
3336C0003X, 3336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR100435407Medicaid
AR0405046OtherNABP