Provider Demographics
NPI:1548206634
Name:CABOT MEDICAL PARK PHARMACY INC
Entity Type:Organization
Organization Name:CABOT MEDICAL PARK PHARMACY INC
Other - Org Name:CABOT MEDICAL PARK PHARMACY INCORPORATED
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:CURD
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:501-281-3600
Mailing Address - Street 1:PO BOX 1242
Mailing Address - Street 2:
Mailing Address - City:CABOT
Mailing Address - State:AR
Mailing Address - Zip Code:72023-1242
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2039 W MAIN ST
Practice Address - Street 2:STE D
Practice Address - City:CABOT
Practice Address - State:AR
Practice Address - Zip Code:72023-7479
Practice Address - Country:US
Practice Address - Phone:501-724-6985
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-20
Last Update Date:2016-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAR205333336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1989607OtherPK