Provider Demographics
NPI:1083381446
Name:PHARMCARE USA OF ARKANSAS, LLC
Entity Type:Organization
Organization Name:PHARMCARE USA OF ARKANSAS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:KENT
Authorized Official - Middle Name:
Authorized Official - Last Name:ABBOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-204-9783
Mailing Address - Street 1:PO BOX 10
Mailing Address - Street 2:
Mailing Address - City:HYDRO
Mailing Address - State:OK
Mailing Address - Zip Code:73048-0010
Mailing Address - Country:US
Mailing Address - Phone:866-219-3619
Mailing Address - Fax:
Practice Address - Street 1:9600 MAUMELLE BLVD
Practice Address - Street 2:
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72113-7252
Practice Address - Country:US
Practice Address - Phone:501-246-3521
Practice Address - Fax:501-353-2528
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-24
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy