Healthcare Provider Details

I. General information

NPI: 1508970393
Provider Name (Legal Business Name): ROSE DRUG OF DOVER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2006
Last Update Date: 05/10/2022
Certification Date: 05/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8880 MARKET ST
DOVER AR
72837-9111
US

IV. Provider business mailing address

8880 MARKET ST
DOVER AR
72837-9111
US

V. Phone/Fax

Practice location:
  • Phone: 479-331-2133
  • Fax: 479-331-4003
Mailing address:
  • Phone: 479-331-2133
  • Fax: 479-331-4003

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number010491
License Number StateAR

VIII. Authorized Official

Name: DR. RICHARD L. HARMON
Title or Position: PHARMACIST
Credential: PD
Phone: 479-331-2133