Provider Demographics
NPI:1982729711
Name:A&E APOTHECARY
Entity Type:Organization
Organization Name:A&E APOTHECARY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:NEIL
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:SR
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:870-285-3645
Mailing Address - Street 1:PO BOX 259
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:71958-0259
Mailing Address - Country:US
Mailing Address - Phone:870-285-3645
Mailing Address - Fax:870-285-3357
Practice Address - Street 1:317 E 13TH
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:AR
Practice Address - Zip Code:71958-0259
Practice Address - Country:US
Practice Address - Phone:870-285-3645
Practice Address - Fax:870-285-3357
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2007-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAR164051835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatricGroup - Single Specialty