Healthcare Provider Details

I. General information

NPI: 1447307590
Provider Name (Legal Business Name): HAH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/04/2007
Last Update Date: 01/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1523 S MAIN ST
HOPE AR
71801-7202
US

IV. Provider business mailing address

1523 S MAIN ST
HOPE AR
71801-7202
US

V. Phone/Fax

Practice location:
  • Phone: 870-777-5555
  • Fax: 870-777-3661
Mailing address:
  • Phone: 870-777-5555
  • Fax: 870-777-3661

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberAR20325
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code3336M0003X
TaxonomyManaged Care Organization Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: KRISTI HAYS
Title or Position: CHIEF PHRM
Credential:
Phone: 870-777-4616