Healthcare Provider Details

I. General information

NPI: 1881703379
Provider Name (Legal Business Name): ROSE DRUG OF DOVER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2006
Last Update Date: 04/19/2022
Certification Date: 04/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

417 UNION ST
DARDANELLE AR
72834-3429
US

IV. Provider business mailing address

417 UNION ST
DARDANELLE AR
72834-3429
US

V. Phone/Fax

Practice location:
  • Phone: 479-228-4811
  • Fax: 479-229-5871
Mailing address:
  • Phone: 479-229-4811
  • Fax: 479-229-5871

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberAR20230
License Number StateAR

VIII. Authorized Official

Name: MR. RICHARD L HARMON
Title or Position: PHARMACIST/OWNER
Credential: P.D.
Phone: 479-229-4811