Provider Demographics
NPI:1568851384
Name:E&F FOWLER INC
Entity Type:Organization
Organization Name:E&F FOWLER INC
Other - Org Name:HORSESHOE HEALTH & MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE
Authorized Official - Prefix:
Authorized Official - First Name:JENIFER
Authorized Official - Middle Name:MICHELE
Authorized Official - Last Name:BLAIR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-670-4580
Mailing Address - Street 1:600 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:HORSESHOE BEND
Mailing Address - State:AR
Mailing Address - Zip Code:72512-3876
Mailing Address - Country:US
Mailing Address - Phone:870-670-4580
Mailing Address - Fax:
Practice Address - Street 1:600 MARKET ST
Practice Address - Street 2:
Practice Address - City:HORSESHOE BEND
Practice Address - State:AR
Practice Address - Zip Code:72512-3876
Practice Address - Country:US
Practice Address - Phone:870-670-4580
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:E&F FOWLER INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-01-16
Last Update Date:2015-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAR20535333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR165787733OtherMEDICAID OLD RX PROVIDER ID
AR49969OtherBCBS
ARE3439OtherEDI SUBMITTER #
AR1427228659OtherBCBS
ARB08007585OtherMEDICARE EDI TRADING PARTNER ID
AR161094407OtherMEDICAID RX PROVIDER ID
AR5F775OtherBCBS
AR162358716Medicaid
AR5F775OtherBCBS
AR1427228659OtherBCBS
AR165787733OtherMEDICAID OLD RX PROVIDER ID