Healthcare Provider Details

I. General information

NPI: 1023715737
Provider Name (Legal Business Name): PHPH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2023
Last Update Date: 02/13/2023
Certification Date: 02/13/2023
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:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: LAURA HARRIS
Title or Position: OWNER/ PHARMACIST IN CHARGE
Credential:
Phone: 870-633-7474