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NPI Code Detail

MEDICARE: SOUTH ARKANSAS OIL CO

MEDICARE: SOUTH ARKANSAS OIL CO
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
13336L0003XLong Term Care Pharmacy
2333600000XPharmacy
33336I0012XInstitutional PharmacyAR20347AR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
31989425OTHERPK

General Provider Information

NPI Number : 1861438772
Entity Type Code : Organization
Provider Name (Legal Business Name) : SOUTH ARKANSAS OIL CO
Provider Business Mailing Address
First Line : PO BOX 9830
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84109-9830
Country : US
Telephone Number : 870-864-0730
Fax Number : 870-864-0522
Provider Business Practice Location Address
First Line : 2710 N WEST AVE
Second Line :
City : EL DORADO
State : AR
Zip : 71730-3124
Country : US
Telephone Number : 870-864-0730
Fax Number : 870-864-0522
Authorized Official
Title or Position : PIC
Name : ALAN HARPER
Credential : RPH
Telephone Number : 870-864-0730
Provider Enumeration Date : 06/20/2006
Last Update Date : 12/01/2016

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Directions to “SOUTH ARKANSAS OIL CO ” Practice Location

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