Provider Demographics
NPI:1568876522
Name:BRFHH MONROE LLC
Entity Type:Organization
Organization Name:BRFHH MONROE LLC
Other - Org Name:UNIVERSITY HEALTH CONWAY OUTPATIENT PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OUTPATIENT PHARMACY SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:TOMI
Authorized Official - Middle Name:
Authorized Official - Last Name:THARP
Authorized Official - Suffix:
Authorized Official - Credentials:RPH, MBA
Authorized Official - Phone:318-330-7819
Mailing Address - Street 1:4864 JACKSON ST
Mailing Address - Street 2:ROOM 1-161-B
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71202-6400
Mailing Address - Country:US
Mailing Address - Phone:318-330-7819
Mailing Address - Fax:318-330-7760
Practice Address - Street 1:4864 JACKSON ST
Practice Address - Street 2:ROOM 1-161-B
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71202-6400
Practice Address - Country:US
Practice Address - Phone:318-330-7819
Practice Address - Fax:318-330-7760
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-18
Last Update Date:2019-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy