MEDICARE: MEDISAV HOMECARE PHARMACIES INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0003X	Community/Retail Pharmacy	AR06707	AR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	48817	OTHER	AR	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1063507861
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDISAV HOMECARE PHARMACIES INC

Provider Business Mailing Address
First Line	:	PO BOX 8
Second Line	:
City	:	CHARLESTON
State	:	AR
Zip	:	72933-0008
Country	:	US
Telephone Number	:	479-965-2160
Fax Number	:	479-965-2076

Provider Business Practice Location Address
First Line	:	621 E MAIN
Second Line	:
City	:	CHARLESTON
State	:	AR
Zip	:	72933
Country	:	US
Telephone Number	:	479-965-2244
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR OF OPERATIONS, IT, COMPLIA
Name	:	JAMIE SCHMALZ
Credential	:
Telephone Number	:	479-452-2210

Provider Enumeration Date	:	10/04/2006
Last Update Date	:	10/20/2023

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