Healthcare Provider Details

I. General information

NPI: 1073164281
Provider Name (Legal Business Name): HARRISBURG FAMILY PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2019
Last Update Date: 09/26/2024
Certification Date: 09/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1104 N ILLINOIS ST STE D
HARRISBURG AR
72432-1145
US

IV. Provider business mailing address

1104 N ILLINOIS ST STE D
HARRISBURG AR
72432-1145
US

V. Phone/Fax

Practice location:
  • Phone: 870-926-3458
  • Fax: 870-336-1949
Mailing address:
  • Phone: 870-578-0670
  • Fax: 870-578-0671

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: DR. RIAN R SNELL
Title or Position: MANAGER/OWNER
Credential: PHARMD
Phone: 870-578-0670