Provider Demographics
NPI:1740340124
Name:BILL'S PHARMACY, INC
Entity type:Organization
Organization Name:BILL'S PHARMACY, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BILL
Authorized Official - Middle Name:P
Authorized Official - Last Name:CRABTREE
Authorized Official - Suffix:
Authorized Official - Credentials:PD
Authorized Official - Phone:870-347-2620
Mailing Address - Street 1:PO BOX 270
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:AR
Mailing Address - Zip Code:72006-0270
Mailing Address - Country:US
Mailing Address - Phone:870-347-2620
Mailing Address - Fax:870-347-2641
Practice Address - Street 1:601 MAIN ST
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:AR
Practice Address - Zip Code:72006-2444
Practice Address - Country:US
Practice Address - Phone:870-347-2620
Practice Address - Fax:870-347-2641
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-08
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAR12508183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR165156407Medicaid