Provider Demographics
NPI:1275534513
Name:CHAPEL PHARMACY INC
Entity Type:Organization
Organization Name:CHAPEL PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:STOVER
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:870-879-1490
Mailing Address - Street 1:3800 CAMDEN RD
Mailing Address - Street 2:SUITE #1
Mailing Address - City:PINE BLUFF
Mailing Address - State:AR
Mailing Address - Zip Code:71603-8480
Mailing Address - Country:US
Mailing Address - Phone:870-879-1490
Mailing Address - Fax:870-879-1920
Practice Address - Street 1:3800 CAMDEN RD
Practice Address - Street 2:SUITE #1
Practice Address - City:PINE BLUFF
Practice Address - State:AR
Practice Address - Zip Code:71603-8480
Practice Address - Country:US
Practice Address - Phone:870-879-1490
Practice Address - Fax:870-879-1920
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAR20195333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1303340001Medicare ID - Type Unspecified