Provider Demographics
NPI:1780761056
Name:USA DRUG & BEAUTY MARKET FRANCHISING
Entity type:Organization
Organization Name:USA DRUG & BEAUTY MARKET FRANCHISING
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP PHARMACY SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:GALEN
Authorized Official - Middle Name:
Authorized Official - Last Name:PERKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-296-3311
Mailing Address - Street 1:1401 S BOULDER AVE
Mailing Address - Street 2:STE 300
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74119-3647
Mailing Address - Country:US
Mailing Address - Phone:918-858-4619
Mailing Address - Fax:918-592-4545
Practice Address - Street 1:2720 E RACE AVE
Practice Address - Street 2:
Practice Address - City:SEARCY
Practice Address - State:AR
Practice Address - Zip Code:72143-4734
Practice Address - Country:US
Practice Address - Phone:501-278-4500
Practice Address - Fax:501-268-7291
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2012-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAR203403336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
0421646OtherNCPDP PROVIDER IDENTIFICATION NUMBER
AR176298716Medicaid
AR148590407Medicaid
0767680005Medicare NSC