Healthcare Provider Details

I. General information

NPI: 1023420445
Provider Name (Legal Business Name): PHPH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2014
Last Update Date: 01/05/2023
Certification Date: 01/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

313 ARKANSAS ST
FORREST CITY AR
72335-2125
US

IV. Provider business mailing address

313 ARKANSAS ST
FORREST CITY AR
72335-2125
US

V. Phone/Fax

Practice location:
  • Phone: 870-633-7474
  • Fax: 870-633-7475
Mailing address:
  • Phone: 870-633-7474
  • Fax: 870-633-7475

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberAR20747
License Number StateAR

VIII. Authorized Official

Name: DR. LAURA ELIZABETH HARRIS
Title or Position: OWNER/PHARMACIST IN CHARGE
Credential: PHARM.D.
Phone: 870-633-7474