Healthcare Provider Details

I. General information

NPI: 1063599934
Provider Name (Legal Business Name): TOTTY ENTERPRISES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/31/2006
Last Update Date: 09/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26 NW 1ST STREET
BEARDEN AR
71720
US

IV. Provider business mailing address

PO 627
BEARDEN AR
71720
US

V. Phone/Fax

Practice location:
  • Phone: 870-687-3814
  • Fax: 870-687-3600
Mailing address:
  • Phone: 870-687-3814
  • Fax: 870-687-3600

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberAR18219
License Number StateAR

VIII. Authorized Official

Name: REBECCA BOYD TOTTY
Title or Position: OWNER/PRESIDENT
Credential: PHARMD
Phone: 870-687-3814