Healthcare Provider Details

I. General information

NPI: 1821537929
Provider Name (Legal Business Name): HAMBURG PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2017
Last Update Date: 08/30/2022
Certification Date: 08/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

302 S MAIN ST
HAMBURG AR
71646-3230
US

IV. Provider business mailing address

302 S MAIN ST
HAMBURG AR
71646-3230
US

V. Phone/Fax

Practice location:
  • Phone: 870-853-2191
  • Fax: 870-853-2199
Mailing address:
  • Phone: 870-853-2191
  • Fax: 870-853-2199

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MRS. BRANDY BOWEN
Title or Position: PIC/PHARMACIST
Credential:
Phone: 870-415-1372