Provider Demographics
NPI:1467693754
Name:W P MALONE INC
Entity Type:Organization
Organization Name:W P MALONE INC
Other - Org Name:PHARMACY CARE OF ARKANSAS
Other - Org Type:Other Name
Authorized Official - Title/Position:COMPLIANCE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:KNIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:778-420-9400
Mailing Address - Street 1:PO BOX 524
Mailing Address - Street 2:
Mailing Address - City:ARKADELPHIA
Mailing Address - State:AR
Mailing Address - Zip Code:71923-0524
Mailing Address - Country:US
Mailing Address - Phone:877-420-9400
Mailing Address - Fax:870-245-1790
Practice Address - Street 1:216 S 13TH ST
Practice Address - Street 2:SUITE B
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72758-4204
Practice Address - Country:US
Practice Address - Phone:479-621-0400
Practice Address - Fax:479-621-7079
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:W P MALONE INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-03-16
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
ARAR206033336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2119387OtherPK