Healthcare Provider Details

I. General information

NPI: 1922656222
Provider Name (Legal Business Name): DAMASCUS RX, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2019
Last Update Date: 02/07/2024
Certification Date: 02/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5A HIGHWAY 124 W
DAMASCUS AR
72039-9251
US

IV. Provider business mailing address

5A HIGHWAY 124 W
DAMASCUS AR
72039-9251
US

V. Phone/Fax

Practice location:
  • Phone: 501-335-7041
  • Fax: 501-335-7028
Mailing address:
  • Phone: 501-335-7041
  • Fax: 501-335-7028

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: CHARLENE PIKE
Title or Position: OWNER/PIC
Credential: PHARMD
Phone: 501-335-7041