Provider Demographics
NPI:1851811939
Name:STAN-KEL PHARMACIES, INC.
Entity Type:Organization
Organization Name:STAN-KEL PHARMACIES, INC.
Other - Org Name:STANLEY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:STANLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-305-1000
Mailing Address - Street 1:2007 WEST BEEBE CAPPS EXP.
Mailing Address - Street 2:
Mailing Address - City:SEARCY
Mailing Address - State:AR
Mailing Address - Zip Code:72143
Mailing Address - Country:US
Mailing Address - Phone:501-305-1000
Mailing Address - Fax:501-305-1002
Practice Address - Street 1:2007 W BEEBE CAPPS EXPY
Practice Address - Street 2:
Practice Address - City:SEARCY
Practice Address - State:AR
Practice Address - Zip Code:72143-5014
Practice Address - Country:US
Practice Address - Phone:501-305-1000
Practice Address - Fax:501-305-1002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-21
Last Update Date:2023-04-28
Deactivation Date:2019-12-16
Deactivation Code:
Reactivation Date:2023-04-28
Provider Licenses
StateLicense IDTaxonomies
333600000X
ARAR194013336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR130306407Medicaid
2170011OtherPK
2170011OtherPK