Provider Demographics
NPI:1942384748
Name:MEDI-QUIK PHARMACY INC
Entity Type:Organization
Organization Name:MEDI-QUIK PHARMACY INC
Other - Org Name:MEDI QUIK PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:WOOLSEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:479-667-4145
Mailing Address - Street 1:810 W COMMERCIAL ST
Mailing Address - Street 2:
Mailing Address - City:OZARK
Mailing Address - State:AR
Mailing Address - Zip Code:72949-3010
Mailing Address - Country:US
Mailing Address - Phone:479-667-4145
Mailing Address - Fax:479-667-4879
Practice Address - Street 1:810 W COMMERCIAL ST
Practice Address - Street 2:
Practice Address - City:OZARK
Practice Address - State:AR
Practice Address - Zip Code:72949-3010
Practice Address - Country:US
Practice Address - Phone:479-667-4145
Practice Address - Fax:479-667-4879
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2022-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X, 3336L0003X
ARAR088523336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR100582407Medicaid
1993771OtherPK
AR100582407Medicaid