Provider Demographics
NPI:1619055761
Name:MED CARE, INC
Entity Type:Organization
Organization Name:MED CARE, INC
Other - Org Name:MEDICAL CENTER PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/PHARMACIST
Authorized Official - Prefix:DR
Authorized Official - First Name:PHIL
Authorized Official - Middle Name:G
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:PD
Authorized Official - Phone:870-483-6391
Mailing Address - Street 1:421 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:TRUMANN
Mailing Address - State:AR
Mailing Address - Zip Code:72472-3116
Mailing Address - Country:US
Mailing Address - Phone:870-483-6391
Mailing Address - Fax:870-483-2710
Practice Address - Street 1:421 W MAIN ST
Practice Address - Street 2:
Practice Address - City:TRUMANN
Practice Address - State:AR
Practice Address - Zip Code:72472-3116
Practice Address - Country:US
Practice Address - Phone:870-483-6391
Practice Address - Fax:870-483-2710
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-02
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAR156933336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR0415693OtherNCPDP NUMBER
ARBM1389572OtherDEA
ARBM1389572OtherDEA