Provider Demographics
NPI:1841355542
Name:KING, ELKA SUMMERS (RPH)
Entity type:Individual
Prefix:
First Name:ELKA
Middle Name:SUMMERS
Last Name:KING
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:ELKA
Other - Middle Name:LOUISE
Other - Last Name:SUMMERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1483 ROCKY RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN HOME
Mailing Address - State:AR
Mailing Address - Zip Code:72653-8445
Mailing Address - Country:US
Mailing Address - Phone:870-491-5244
Mailing Address - Fax:
Practice Address - Street 1:400 S COLLEGE ST
Practice Address - Street 2:
Practice Address - City:MOUNTAIN HOME
Practice Address - State:AR
Practice Address - Zip Code:72653-3923
Practice Address - Country:US
Practice Address - Phone:870-425-5145
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD10422183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist