Healthcare Provider Details

I. General information

NPI: 1093720617
Provider Name (Legal Business Name): VILLAGE APOTHECARY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2006
Last Update Date: 07/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4440 N HIGHWAY 7
HOT SPRINGS VILLAGE AR
71909-9301
US

IV. Provider business mailing address

4440 N HIGHWAY 7
HOT SPRINGS VILLAGE AR
71909-9301
US

V. Phone/Fax

Practice location:
  • Phone: 501-922-0777
  • Fax: 501-922-0787
Mailing address:
  • Phone: 501-922-0777
  • Fax: 801-716-4872

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberAR06973
License Number StateAR

VIII. Authorized Official

Name: MICHAEL BUTLER
Title or Position: PRESIDENT
Credential: PHARM.D.
Phone: 501-620-4053