Provider Demographics
NPI:1407188808
Name:USA DRUG & BEAUTY MARKET FRANCHISING SYSTEMS INC
Entity Type:Organization
Organization Name:USA DRUG & BEAUTY MARKET FRANCHISING SYSTEMS INC
Other - Org Name:USA DRUG EXPRESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:KEAVENY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-277-7811
Mailing Address - Street 1:1401 S BOULDER AVE
Mailing Address - Street 2:STE 300
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74119-3647
Mailing Address - Country:US
Mailing Address - Phone:918-858-4632
Mailing Address - Fax:
Practice Address - Street 1:3130 E RACE AVE
Practice Address - Street 2:
Practice Address - City:SEARCY
Practice Address - State:AR
Practice Address - Zip Code:72143-4867
Practice Address - Country:US
Practice Address - Phone:501-368-0560
Practice Address - Fax:501-368-0581
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-10
Last Update Date:2011-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
ARAR206233336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
0423373OtherNCPDP PROVIDER IDENTIFICATION NUMBER
AR180654407Medicaid