Provider Demographics
NPI:1689355489
Name:FRUCHEY, INC
Entity Type:Organization
Organization Name:FRUCHEY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WALTER
Authorized Official - Middle Name:LYN
Authorized Official - Last Name:FRUCHEY
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:501-374-2207
Mailing Address - Street 1:400 W CAPITOL AVE STE 101A
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72201-3436
Mailing Address - Country:US
Mailing Address - Phone:501-374-2207
Mailing Address - Fax:501-374-2208
Practice Address - Street 1:400 W CAPITOL AVE STE 101A
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72201-3436
Practice Address - Country:US
Practice Address - Phone:501-374-2207
Practice Address - Fax:501-374-2208
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FRUCHEY, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-07-26
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy