Healthcare Provider Details

I. General information

NPI: 1164290276
Provider Name (Legal Business Name): FARMAKEIO AR LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2023
Last Update Date: 12/18/2023
Certification Date: 12/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1270 DONS LN
CONWAY AR
72032-4753
US

IV. Provider business mailing address

1270 DONS LN
CONWAY AR
72032-4753
US

V. Phone/Fax

Practice location:
  • Phone: 501-504-7112
  • Fax:
Mailing address:
  • Phone: 501-504-7112
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DR. NATHAN GRIFFORD
Title or Position: PHARMACIST IN CHARGE
Credential: PHARMD
Phone: 501-504-7112