Healthcare Provider Details

I. General information

NPI: 1730198110
Provider Name (Legal Business Name): HEALTH DEPOT PHARMACIES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2006
Last Update Date: 09/14/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1610 FORT STREET
BARLING AR
72923
US

IV. Provider business mailing address

7700 HWY 271 S
FORT SMITH AR
72908-8028
US

V. Phone/Fax

Practice location:
  • Phone: 479-452-1237
  • Fax: 479-452-7953
Mailing address:
  • Phone: 479-646-7875
  • Fax: 479-646-7875

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberAR20079
License Number StateAR

VIII. Authorized Official

Name: JOHN HENRY HALL
Title or Position: PRESIDENT
Credential: RPH
Phone: 479-646-7875