Healthcare Provider Details

I. General information

NPI: 1629755988
Provider Name (Legal Business Name): RIVER BEND PHARMACY GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2023
Last Update Date: 07/16/2024
Certification Date: 08/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

313 MAIN ST
DES ARC AR
72040-7905
US

IV. Provider business mailing address

105 BARTLETT RD
SEARCY AR
72143-8653
US

V. Phone/Fax

Practice location:
  • Phone: 870-256-4317
  • Fax: 870-256-3387
Mailing address:
  • Phone: 870-256-4317
  • Fax: 870-256-3387

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DONALD PEYTON HARVEY
Title or Position: OWNER
Credential: PHARM D
Phone: 870-256-4317