Provider Demographics
NPI:1134223183
Name:SEARCY MEDICAL CENTER PHARMACY LLP
Entity type:Organization
Organization Name:SEARCY MEDICAL CENTER PHARMACY LLP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CASEY
Authorized Official - Middle Name:
Authorized Official - Last Name:MCLEOD
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:501-268-3311
Mailing Address - Street 1:2505 W BEEBE CAPPS EXPY
Mailing Address - Street 2:STE 100
Mailing Address - City:SEARCY
Mailing Address - State:AR
Mailing Address - Zip Code:72143-4909
Mailing Address - Country:US
Mailing Address - Phone:501-268-3456
Mailing Address - Fax:501-279-2675
Practice Address - Street 1:2505 W BEEBE CAPPS EXPY
Practice Address - Street 2:STE 100
Practice Address - City:SEARCY
Practice Address - State:AR
Practice Address - Zip Code:72143-4909
Practice Address - Country:US
Practice Address - Phone:501-268-3456
Practice Address - Fax:501-279-2675
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-12
Last Update Date:2013-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
ARAR205093336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1989587OtherPK
AR157803407Medicaid