Healthcare Provider Details

I. General information

NPI: 1194658336
Provider Name (Legal Business Name): NATURAL STATE DRUG COMPANY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2026
Last Update Date: 06/06/2026
Certification Date: 06/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2405 HIGHWAY 5 N STE 300
BENTON AR
72019-6330
US

IV. Provider business mailing address

2405 HIGHWAY 5 N STE 300
BENTON AR
72019-6330
US

V. Phone/Fax

Practice location:
  • Phone: 501-860-2566
  • Fax: 501-860-2566
Mailing address:
  • Phone: 501-860-2566
  • Fax: 501-860-2566

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: JACQUELINE POZAREK
Title or Position: PHARMACIST
Credential:
Phone: 501-860-2566