Provider Demographics
NPI:1497587083
Name:ICARERX, INC
Entity type:Organization
Organization Name:ICARERX, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST / OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:ERIC
Authorized Official - Last Name:SHOFFNER
Authorized Official - Suffix:
Authorized Official - Credentials:BPHARM
Authorized Official - Phone:870-364-5100
Mailing Address - Street 1:909 UNITY RD
Mailing Address - Street 2:
Mailing Address - City:CROSSETT
Mailing Address - State:AR
Mailing Address - Zip Code:71635-9444
Mailing Address - Country:US
Mailing Address - Phone:870-364-5100
Mailing Address - Fax:870-364-5120
Practice Address - Street 1:909 UNITY RD
Practice Address - Street 2:
Practice Address - City:CROSSETT
Practice Address - State:AR
Practice Address - Zip Code:71635-9444
Practice Address - Country:US
Practice Address - Phone:870-364-5100
Practice Address - Fax:870-364-5120
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-14
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory CareGroup - Multi-Specialty